Individual provider Active NPI

Michael Thomas Marks, DC

  • Chiropractor
  • Costa Mesa, CA
National Provider Identifier
1508169269
Registry record updated Dec 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC31689 Issued in CA
Practice address
2900 Bristol St
Suite C-105
Costa Mesa, CA 92626-5981
Phone
(714) 557-9454
Fax
(714) 557-9534
NPI assigned
Dec 17, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC31689 CA Primary

Addresses

Primary practice location

2900 Bristol St
Suite C-105
Costa Mesa, CA 92626-5981

Mailing address

2900 Bristol St
Suite C-105
Costa Mesa, CA 92626-5981
Phone (714) 557-9454

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250403001004 CA Practitioner - Chiropractic 8123492857 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC31689CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Twins Physical Medicine Corp CurrentSince Jan 2, 2025 Accepting new patients
Twins Wellness Chiropractor PastSince Jan 2, 2025 Accepting new patients

Locations

400 Ramona Ave
Ste 113
Corona, CA 92879
Phone (714) 621-0327

13311 Garden Grove Blvd
Ste B
Garden Grove, CA 92843
Phone (714) 621-0312

Organizations & group practices 2

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": "1292544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292544000000",
    "number": "1508169269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST",
            "address_2": "SUITE C-105",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265981",
            "telephone_number": "714-557-9454",
            "fax_number": "714-557-9534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST",
            "address_2": "SUITE C-105",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265981",
            "telephone_number": "714-557-9454",
            "fax_number": "714-557-9534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-17",
        "last_updated": "2010-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC31689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2010; 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.