Active NPI
Glenn Joseph Skene, D.C.
- Chiropractor
- Tustin, CA
National Provider Identifier
1366676843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC12540
- Practice address
- 17842 Irvine Blvd
#126
Tustin, CA 92780-3203 - Phone
- (714) 336-7049
- Fax
- (714) 486-2302
- NPI assigned
- May 12, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC12540 | CA | Primary |
Addresses
Primary practice location
17842 Irvine Blvd
#126
Tustin, CA 92780-3203
Mailing address
17842 Irvine Blvd
#126
Tustin, CA 92780-3203
Phone (714) 336-7049
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC12540 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425427200000",
"number": "1366676843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17842 IRVINE BLVD",
"address_2": "#126",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927803203",
"telephone_number": "714-336-7049",
"fax_number": "714-486-2302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17842 IRVINE BLVD",
"address_2": "#126",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927803203",
"telephone_number": "714-336-7049",
"fax_number": "714-486-2302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKENE",
"first_name": "GLENN",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-12",
"last_updated": "2015-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC12540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.