NPIMap

Organization Active NPI

Pellicani Chiropractic Corp

  • Chiropractor
  • Campbell, CA
National Provider Identifier
1356469464
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC16755 Issued in CA
Legal business name
PELLICANI CHIROPRACTIC CORP
Practice address
430 Marathon Dr
Campbell, CA 95008-0918
Phone
(408) 378-2225
Fax
(408) 370-6653
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Giti Mokhber Pellicani, DCNPI 1053487686
Title
President
Phone
(408) 378-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC16755 CA Primary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC26233 CA

Addresses

Primary practice location

430 Marathon Dr
Campbell, CA 95008-0918

Mailing address

430 Marathon Dr
Campbell, CA 95008-0918
Phone (408) 378-2225

Other names 1

  • Neck and Back Chiropractic Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051007000548 CA Part B Supplier - Clinic/Group Practice 8628093721 Receives reassigned benefits from 2 practitioners
Practice locations: Campbell, CA

National Provider Directory

National Provider Directory

Locations

430 Marathon Dr
Campbell, CA 95008
Phone (408) 378-2225

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1356469464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MARATHON DR",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080918",
            "telephone_number": "408-378-2225",
            "fax_number": "408-370-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MARATHON DR",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080918",
            "telephone_number": "408-378-2225",
            "fax_number": "408-370-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELLICANI CHIROPRACTIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "MOKHBER PELLICANI",
        "authorized_official_first_name": "GITI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-378-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC16755",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC26233",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neck And Back Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Neck and Back Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.