Russell S Revilla, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC20363 Issued in CA

Practice address

555 S Rancho Santa Fe Rd
Suite 200
San Marcos, CA 92078-3698

Phone

(760) 736-0286

Fax

(760) 736-3113

NPI assigned

Jul 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Andrew Tutino Chiropractic Inc.

  • Chiropractor
  • Lemon Grove, CA
  • NPI 1356613707
  NPD (past)
• Greg Ninberg Chiropractic Corporation

  • Chiropractor
  • Lemon Grove, CA
  • NPI 1679206528
  NPD (past)

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407877517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S RANCHO SANTA FE RD",
            "address_2": "SUITE 200",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920783698",
            "telephone_number": "760-736-0286",
            "fax_number": "760-736-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S RANCHO SANTA FE RD",
            "address_2": "SUITE 200",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920783698",
            "telephone_number": "760-736-0286",
            "fax_number": "760-736-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVILLA",
        "first_name": "RUSSELL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC20363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constantine Nicolas Reppas, D.M.D
• Mireya Resendez
• Brene Breanna Resendiz Baltazar
• Christina Resendiz
• Revilla Chiropractic a Professional Corporation
• Jaidee Mae Reyes, OTR/L
• Nancy Inge Reyes, CPSS, RAOD
• Ruby Reyes
• Veronica Reyes, MD
• Vianet Reyes

• Chiropractor in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.