So Cal Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC24008 Issued in CA

Legal business name

SO CAL CHIROPRACTIC

Practice address

129 W Wilson St
Ste 104
Costa Mesa, CA 92627-1586

Phone

(949) 548-7767

Fax

(949) 548-5692

NPI assigned

Nov 28, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Ace S Thayer, DC

Title

Owner

Phone

(949) 548-7767

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1477898781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 W WILSON ST",
            "address_2": "STE 104",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926271586",
            "telephone_number": "949-548-7767",
            "fax_number": "949-548-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 W WILSON ST",
            "address_2": "STE 104",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926271586",
            "telephone_number": "949-548-7767",
            "fax_number": "949-548-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SO CAL CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "THAYER",
        "authorized_official_first_name": "ACE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-548-7767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC24008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.