Individual provider Active NPI

Mohsen Khamessipour, DC

  • Chiropractor
  • Lake Forest, CA
National Provider Identifier
1356833743
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC20248 Issued in CA
Practice address
22972 El Toro Rd
Lake Forest, CA 92630-4961
Phone
(949) 447-4484
NPI assigned
Jun 1, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC20248 CA Primary

Addresses

Primary practice location

22972 El Toro Rd
Lake Forest, CA 92630-4961

Mailing address

22972 El Toro Rd
Lake Forest, CA 92630-4961
Phone (949) 447-4484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC20248CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1356833743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22972 EL TORO RD",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304961",
            "telephone_number": "949-447-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22972 EL TORO RD",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304961",
            "telephone_number": "949-447-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMESSIPOUR",
        "first_name": "MOHSEN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-01",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC20248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; 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.