NPIMap

Organization Active NPI

Back in Action Chiropractic

  • Rehabilitation Chiropractor
  • Valley Village, CA
National Provider Identifier
1356542914
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
26939 Issued in CA
Legal business name
BACK IN ACTION CHIROPRACTIC
Practice address
12626 Riverside Dr
Suite #512
Valley Village, CA 91607-3420
Phone
(818) 285-6333
Fax
(818) 285-6335
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Theofiel Vanlondersele, D.C.
Title
Partner
Phone
(818) 285-6333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X 26939 CA Primary

Addresses

Primary practice location

12626 Riverside Dr
Suite #512
Valley Village, CA 91607-3420

Mailing address

12626 Riverside Dr
Suite #512
Valley Village, CA 91607-3420
Phone (818) 285-6333

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356542914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12626 RIVERSIDE DR",
            "address_2": "SUITE #512",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073420",
            "telephone_number": "818-285-6333",
            "fax_number": "818-285-6335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12626 RIVERSIDE DR",
            "address_2": "SUITE #512",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073420",
            "telephone_number": "818-285-6333",
            "fax_number": "818-285-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN ACTION CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VANLONDERSELE",
        "authorized_official_first_name": "THEOFIEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "818-285-6333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "26939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.