Mark Metildi, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC20703 Issued in CA

Practice address

629 Camino de Los Mares
Suite 104
San Clemente, CA 92673-2829

Phone

(949) 240-1334

NPI assigned

Oct 21, 2008

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.

• David Ahrens

  • Chiropractor
  • San Clemente, CA
  • NPI 1114101953
  NPD (past)
• Russell Thompson Chiropractic Inc

  • Clinic/Center
  • San Clemente, CA
  • NPI 1174046874
  NPD (past)

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1427200633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3546 EL CAMINO REAL",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934222532",
            "telephone_number": "805-466-6378",
            "fax_number": "805-466-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 CAMINO DE LOS MARES",
            "address_2": "SUITE 104",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732829",
            "telephone_number": "949-240-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METILDI",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC20703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Melville, MD
• Memorialcare Imaging Center at San Clemente, LLC
• Veena Menda, M.D
• Janelle Anne Mercuro, RD
• Meighan Bartholomew Merono, PHARMD
• Metz-Schade Corp.
• Michael a. Shannon, D.D.S., M.S., Inc
• Michael L Kreutz Chiropractic Inc
• Michelle Hannemann
• Chloe Nicole Miller, NATUROPATHIC DOCTOR

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.

Verify at the official NPI Registry.