Active NPI
Mark Peter Lungren, DC
- Chiropractor
- Selma, CA
National Provider Identifier
1427090513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC27808
- Practice address
- 1850 Floral Avenue
Selma, CA 93662-2808 - Phone
- (559) 896-3075
- Fax
- (559) 896-3077
- NPI assigned
- Jun 12, 2006
- 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 | DC27808 | CA | Primary |
Addresses
Primary practice location
1850 Floral Avenue
Selma, CA 93662-2808
Mailing address
1850 Floral Avenue
Selma, CA 93662-2808
Phone (559) 896-3075
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC0278080 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| DC27808 | CA | MD | Chiropractor |
| 27808 | CA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191888000000",
"number": "1427090513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1850 FLORAL AVENUE",
"city": "SELMA",
"state": "CA",
"postal_code": "936622808",
"telephone_number": "559-896-3075",
"fax_number": "559-896-3077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1850 FLORAL AVENUE",
"city": "SELMA",
"state": "CA",
"postal_code": "936622808",
"telephone_number": "559-896-3075",
"fax_number": "559-896-3077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNGREN",
"first_name": "MARK",
"middle_name": "PETER",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2007-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC27808",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DC0278080",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Selma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.