Active NPI
Leilani M Vidal, D.C.
- Chiropractor
- Poway, CA
National Provider Identifier
1518091396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC22198
- Practice address
- 12455 Poway Rd
Suite G
Poway, CA 92064-4320 - Phone
- (858) 679-5544
- NPI assigned
- Mar 15, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 | DC22198 | CA | Primary |
Addresses
Primary practice location
12455 Poway Rd
Suite G
Poway, CA 92064-4320
Mailing address
12455 Poway Rd
Suite G
Poway, CA 92064
Phone (858) 679-5544
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC22198 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518091396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12455 POWAY RD",
"address_2": "SUITE G",
"city": "POWAY",
"state": "CA",
"postal_code": "92064",
"telephone_number": "858-679-5544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12455 POWAY RD",
"address_2": "SUITE G",
"city": "POWAY",
"state": "CA",
"postal_code": "920644320",
"telephone_number": "858-679-5544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDAL",
"first_name": "LEILANI",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC22198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poway, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.