Organization Active NPI

Hubbard Chiropractic Inc

Doing business as Convoy Village Chiropractic

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1487889218
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC28496 Issued in CA
Legal business name
HUBBARD CHIROPRACTIC INC
Doing business as
Convoy Village Chiropractic
Practice address
4344 Convoy St Ste K
San Diego, CA 92111-3737
Phone
(858) 279-7300
NPI assigned
May 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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

Authorized official

Name
Dr. Matthew Alexander Hubbard, D.C.NPI 1578650131
Title
Owner
Phone
(858) 279-7300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC28496 CA Primary

Addresses

Primary practice location

4344 Convoy St Ste K
San Diego, CA 92111-3737

Mailing address

4344 Convoy St Ste K
San Diego, CA 92111-3737
Phone (858) 279-7300

Other names 1

  • Convoy Village Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130220000077 CA Part B Supplier - Clinic/Group Practice 0749435907 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

4344 Convoy St
Ste C1
San Diego, CA 92111
Phone (240) 601-0261

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362441600000",
    "number": "1487889218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4344 CONVOY ST STE K",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113737",
            "telephone_number": "858-279-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4344 CONVOY ST STE K",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113737",
            "telephone_number": "858-279-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUBBARD CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-22",
        "last_updated": "2013-03-05",
        "status": "A",
        "authorized_official_last_name": "HUBBARD",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-279-7300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Convoy Village Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.