Eddy Mydouangchanh

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

34895 Issued in CA

Practice address

550 S Eremland Dr
Covina, CA 91723-3100

Phone

(626) 332-7829

Fax

(626) 332-7829

NPI assigned

Jan 18, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, CA2 enrollments

Enrollment records 2

Specialty

Chiropractic

Education

Western States College of Chiropractic, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eddy Crypto Chiropractic CorporationGroup PAC ID 5799140273, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eddy Crypto Chiropractic Corporation

  • Chiropractor
  • Covina, CA
  • NPI 1063112555
  Medicare reassignment Care Compare group NPD Authorized official
• Sunnybrook Chiropractic Corp

  • Chiropractor
  • Milwaukie, OR
  • NPI 1376184564
  Medicare reassignment NPD
• Broberg Chiropractic Clinic

  • Chiropractor
  • Covina, CA
  • NPI 1336854538
  NPD Authorized official

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

{
    "created_epoch": "1390003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1497177844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S EREMLAND DR",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917233100",
            "telephone_number": "626-332-7829",
            "fax_number": "626-332-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S EREMLAND DR",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917233100",
            "telephone_number": "626-332-7829",
            "fax_number": "626-332-7829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2305 SE Washington St",
            "address_purpose": "LOCATION",
            "city": "Milwaukie",
            "state": "OR",
            "postal_code": "972227647",
            "country_code": "US",
            "telephone_number": "503-305-8825",
            "fax_number": "503-303-4389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYDOUANGCHANH",
        "first_name": "EDDY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-18",
        "last_updated": "2023-04-26",
        "certification_date": "2023-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5542",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patsy R Murillo
• Ariana Rose Murphy
• Edward John Murphy
• Katie Murry
• John Musharbash
• Su Wai Myo, MD
• William E. Myrvold
• Angela K Naccashian, RD
• Nageswara R Guntupalli MD Inc
• Maikel Nagib

• Chiropractor in Covina, CA
• Providers in Covina, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.