Organization Active NPI

Porath Chiropractic Corporation

  • Chiropractor
  • Orange, CA
National Provider Identifier
1366767451
Registry record updated Dec 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC26124 Issued in CA
Legal business name
PORATH CHIROPRACTIC CORPORATION
Practice address
1748 W Katella Ave
107
Orange, CA 92867-3437
Phone
(714) 313-4212
Fax
(714) 464-5365
NPI assigned
Mar 31, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2014

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

Authorized official

Name
William T Porath, D.C.NPI 1659696748
Title
Owner / Provider
Phone
(714) 313-4212

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC26124 CA Primary

Addresses

Primary practice location

1748 W Katella Ave
107
Orange, CA 92867-3437

Mailing address

15550 Rockfield Blvd
B220
Irvine, CA 92618-2720
Phone (949) 598-9999

Other identifiers 3

IdentifierTypeStateIssuer
DC26124OtherCAD.C. LICENSE
INDIVIDUAL NPIOtherCA1659696748
ZZZ03106ZOtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101117001056 CA Part B Supplier - Clinic/Group Practice 2961697842 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

1748 W Katella Ave
Ste 107
Orange, CA 92867
Phone (714) 313-4212

3660 Clairemont Dr
Ste 1B
San Diego, CA 92117
Phone (714) 313-4212

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": "1269993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417392000000",
    "number": "1366767451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15550 ROCKFIELD BLVD",
            "address_2": "B220",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182720",
            "telephone_number": "949-598-9999",
            "fax_number": "949-598-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1748 W KATELLA AVE",
            "address_2": "107",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928673437",
            "telephone_number": "714-313-4212",
            "fax_number": "714-464-5365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORATH CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-31",
        "last_updated": "2014-12-01",
        "status": "A",
        "authorized_official_last_name": "PORATH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER / PROVIDER",
        "authorized_official_telephone_number": "714-313-4212",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC26124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "D.C. LICENSE",
            "identifier": "DC26124",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1659696748",
            "identifier": "INDIVIDUAL NPI",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ03106Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; 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.