Organization Active NPI

Rejuvaspine Chiropractic

  • Chiropractor
  • Stockton, CA
National Provider Identifier
1508196486
Registry record updated Dec 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC31436 Issued in CA
Legal business name
REJUVASPINE CHIROPRACTIC
Practice address
3322 E Hammer LN
Suite I
Stockton, CA 95212-3843
Phone
(209) 957-8808
NPI assigned
Dec 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2009

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

Authorized official

Name
Thong Huu Nguyen, D.C.NPI 1831426923
Title
Partner
Phone
(209) 957-8808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X DC31436 CA Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X DC31400 CA

Addresses

Primary practice location

3322 E Hammer LN
Suite I
Stockton, CA 95212-3843

Mailing address

3322 E Hammer LN
Suite I
Stockton, CA 95212-3843
Phone (209) 957-8808

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091223000519 CA Part B Supplier - Clinic/Group Practice 1557401569 Receives reassigned benefits from 1 practitioner
Practice locations: Stockton, CA

National Provider Directory

National Provider Directory

Locations

3322 E Hammer Ln
Ste 1
Stockton, CA 95212
Phone (209) 957-8808

3322 E Hammer Ln
Ste I
Stockton, CA 95212
Phone (209) 957-8808

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261958400000",
    "number": "1508196486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3322 E HAMMER LN",
            "address_2": "SUITE I",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952123843",
            "telephone_number": "209-957-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 E HAMMER LN",
            "address_2": "SUITE I",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952123843",
            "telephone_number": "209-957-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVASPINE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-28",
        "last_updated": "2009-12-28",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "THONG",
        "authorized_official_middle_name": "HUU",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "209-957-8808",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC31436",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC31400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; 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.