Individual provider Active NPI

Corey Lichtman, D.C.

  • Chiropractor
  • Solana Beach, CA
National Provider Identifier
1508854803
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC29245 Issued in CA
Practice address
634 Stevens Ave
Solana Beach, CA 92075-2422
Phone
(858) 350-6290
Fax
(858) 350-6775
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC29245 CA Primary

Addresses

Primary practice location

634 Stevens Ave
Solana Beach, CA 92075-2422

Mailing address

634 Stevens Ave
Solana Beach, CA 92075-2422
Phone (858) 350-6290

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061020000334 CA Practitioner - Chiropractic 4981600665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

560 Stevens Ave
Solana Beach, CA 92075-2054
Phone (858) 876-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC29245CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lichtman Chiropractic Inc Chiropractor CurrentSince Feb 1, 2013 Accepting new patients
Sheppard Spine & Sports Clinic Chiropractor Past Accepting new patients

Locations

15520 Rockfield Blvd
Ste A200
Irvine, CA 92618

616 Stevens Ave
Ste D
Solana Beach, CA 92075
Phone (858) 481-1889

560 Stevens Ave
Solana Beach, CA 92075
Phone (209) 259-9270

634 Stevens Ave
Solana Beach, CA 92075
Phone (858) 350-6290

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1508854803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 STEVENS AVE",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920752422",
            "telephone_number": "858-350-6290",
            "fax_number": "858-350-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 STEVENS AVE",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920752422",
            "telephone_number": "858-350-6290",
            "fax_number": "858-350-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTMAN",
        "first_name": "COREY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC29245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Solana Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; 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.