Individual provider Active NPI

Clifford Richard Hallum, D.C.

  • Chiropractor
  • Fullerton, CA
National Provider Identifier
1487839346
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC19815 Issued in CA
Practice address
301 N Raymond Ave
Fullerton, CA 92831-3822
Phone
(714) 525-8767
Fax
(714) 525-8795
NPI assigned
Jan 9, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC19815 CA Primary

Addresses

Primary practice location

301 N Raymond Ave
Fullerton, CA 92831-3822

Mailing address

301 N Raymond Ave
Fullerton, CA 92831-3822
Phone (714) 525-8767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120315000282 CA Practitioner - Chiropractic 4183883812 Practice locations: Fullerton, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

301 N Raymond Ave
Fullerton, CA 92831-3822
Phone (714) 525-8767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC19815CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Priscilla Chan Acupuncture Past Accepting new patients

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": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1487839346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N RAYMOND AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313822",
            "telephone_number": "714-525-8767",
            "fax_number": "714-525-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N RAYMOND AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313822",
            "telephone_number": "714-525-8767",
            "fax_number": "714-525-8795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLUM",
        "first_name": "CLIFFORD",
        "middle_name": "RICHARD",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-09",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC19815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.