Active NPI
Richard Trujillo, DC
- Chiropractor
- Grand Terrace, CA
National Provider Identifier
1437589637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC32682
- Practice address
- 12139 Mount Vernon Ave Ste 100
Grand Terrace, CA 92313-5519 - Phone
- (909) 783-4950
- NPI assigned
- Nov 25, 2013
- 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 | DC32682 | CA | Primary |
Addresses
Primary practice location
12139 Mount Vernon Ave Ste 100
Grand Terrace, CA 92313-5519
Mailing address
15985 Winnebago Rd
Apple Valley, CA 92307-3049
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 |
|---|---|---|---|
| DC32682 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Keough Chiropractic, Inc | Chiropractor | Past | Accepting new patients |
| Bissani Chiropractic and Integrated Health PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Grand Terrace Chiropractic
- Clinic/Center
- Grand Terrace, CA
- NPI 1306457916
-
- Chiropractor
- Grand Terrace, CA
- NPI 1104026913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385337600000",
"number": "1437589637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15985 WINNEBAGO RD",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923073049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12139 MOUNT VERNON AVE STE 100",
"city": "GRAND TERRACE",
"state": "CA",
"postal_code": "923135519",
"telephone_number": "909-783-4950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUJILLO",
"first_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-25",
"last_updated": "2013-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC32682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Terrace, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.