Active NPI
Michael Thomas Marks, DC
- Chiropractor
- Costa Mesa, CA
National Provider Identifier
1508169269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC31689
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC31689 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Twins Physical Medicine Corp | Current | Accepting new patients | |
| Twins Wellness | Chiropractor | Past | 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.
-
- Preferred Provider Organization
- Garden Grove, CA
- NPI 1689049785
-
- Chiropractor
- Garden Grove, CA
- NPI 1982949574
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.