Active NPI
Mar Vista Health Center, Inc
- Chiropractor
- Los Angeles, CA
National Provider Identifier
1497076277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC27775
- Legal business name
- MAR VISTA HEALTH CENTER, INC
- Practice address
- 3030 Sawtelle Blvd
Los Angeles, CA 90066-1408 - Phone
- (310) 391-2617
- Fax
- (310) 390-0868
- NPI assigned
- Jun 16, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Wayne Higashi, DC
- Title
- Executive
- Phone
- (310) 391-2617
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC27775 | CA | Primary |
| Chiropractor | 111N00000X | DC27651 | CA | |
| Chiropractor | 111N00000X | DC30839 | CA | |
| Acupuncturist | 171100000X | AC10834 | CA | |
| Acupuncturist | 171100000X | AC3057 | CA | |
| Physical Medicine & Rehabilitation Physician | 208100000X | G65692 | CA | |
| Physical Medicine & Rehabilitation Physician | 208100000X | C51939 | CA |
Addresses
Primary practice location
3030 Sawtelle Blvd
Los Angeles, CA 90066-1408
Mailing address
3030 Sawtelle Blvd
Los Angeles, CA 90066-1408
Phone (310) 391-2617
Other names 1
- Sinel Medical Corporation
National Provider Directory
National Provider DirectoryLocations
3030 Sawtelle Blvd
Los Angeles, CA 90066
Phone (310) 390-9018
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Non-Pharmacy Dispensing Site
- Los Angeles, CA
- NPI 1720301559
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276646400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1293494400000",
"number": "1497076277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3030 SAWTELLE BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900661408",
"telephone_number": "310-391-2617",
"fax_number": "310-390-0868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3030 SAWTELLE BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900661408",
"telephone_number": "310-391-2617",
"fax_number": "310-390-0868"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAR VISTA HEALTH CENTER, INC",
"organizational_subpart": "NO",
"enumeration_date": "2010-06-16",
"last_updated": "2010-12-28",
"status": "A",
"authorized_official_last_name": "HIGASHI",
"authorized_official_first_name": "WAYNE",
"authorized_official_title_or_position": "EXECUTIVE",
"authorized_official_telephone_number": "310-391-2617",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "CA",
"license": "DC27775",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "CA",
"license": "DC27651",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "CA",
"license": "DC30839",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC10834",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC3057",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": "CA",
"license": "G65692",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": "CA",
"license": "C51939",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Sinel Medical Corporation",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.