Individual provider Active NPI

Joshua Bravo Beltran, DC

  • Chiropractor
  • Tustin, CA
National Provider Identifier
1497394456
Registry record updated Dec 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
34652 Issued in CA
Practice address
210 W Main St Ste 102
Tustin, CA 92780-7701
Phone
(714) 398-8524
NPI assigned
Dec 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 34652 CA
Chiropractor 111N00000X 34652 CA Primary

Addresses

Primary practice location

210 W Main St Ste 102
Tustin, CA 92780-7701

Mailing address

432 W Linden Dr
Orange, CA 92865-5004
Phone (724) 349-2462

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201214000962 CA Practitioner - Chiropractic 3173935327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bloch Chiropractic Wellness and Sports Medicine PCGroup PAC ID 5193948792, 4 clinicians

Practice addresses (Care Compare)

6324 E Pacific Coast Hwy
Suite C
Long Beach, CA 90803-4840
Phone (562) 493-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34652CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bloch Chiropractic Wellness and Sports Medicine PC Chiropractor CurrentSince Nov 10, 2020 Accepting new patients

Locations

6324 E Pacific Coast Hwy
Ste C
Long Beach, CA 90803
Phone (562) 493-5600

6342 Industry Way
Ste B
Westminster, CA 92683
Phone (714) 406-4306

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": "1576972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576972800000",
    "number": "1497394456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 W LINDEN DR",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928655004",
            "telephone_number": "724-349-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W MAIN ST STE 102",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807701",
            "telephone_number": "714-398-8524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELTRAN",
        "first_name": "JOSHUA",
        "middle_name": "BRAVO",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-22",
        "last_updated": "2019-12-22",
        "certification_date": "2019-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "34652",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2019; 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.