Individual provider Active NPI

Mina Roshanker, D.C.

  • Chiropractor
  • Tustin, CA
National Provider Identifier
1477075588
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
33949 Issued in CA
Practice address
1076 E. 1St Street Suite a
Tustin, CA 92780-3852
Phone
(949) 756-1003
NPI assigned
Jul 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 33949 CA Primary

Addresses

Primary practice location

1076 E. 1St Street Suite a
Tustin, CA 92780-3852

Mailing address

1076 E. 1St Street Suite a
Tustin, CA 92780
Phone (949) 756-1003

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

LicenseStateTypeSpecialty
33949CAMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Mina Roshankar Chiropractic Inc Chiropractor Current Accepting new patients

Locations

610 Pacific Coast Hwy
Ste 205
Seal Beach, CA 90740
Phone (323) 445-4476

1076 E 1st St
Ste A
Tustin, CA 92780
Phone (949) 304-8759

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1477075588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 E. 1ST STREET SUITE A",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "92780",
            "telephone_number": "949-756-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 E. 1ST STREET SUITE A",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803852",
            "telephone_number": "949-756-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSHANKER",
        "first_name": "MINA",
        "name_prefix": "Miss",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.