Active NPI
Alissa A Rutkoski, D.C.
- Chiropractor
- San Diego, CA
National Provider Identifier
1518296227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 30407
- Practice address
- 3503 4TH Ave
San Diego, CA 92103-4912 - Phone
- (619) 501-7873
- Fax
- (619) 501-7883
- NPI assigned
- Dec 9, 2009
- Last updated
- Dec 9, 2009
- Sex
- Female
- Sole proprietor
- No
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 | 30407 | CA | Primary |
Addresses
Primary practice location
3503 4TH Ave
San Diego, CA 92103-4912
Mailing address
3503 4TH Ave
San Diego, CA 92103-4912
Phone (619) 501-7873
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 |
|---|---|---|---|
| 30407 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cannon & Rutkoski Chiropractic | Chiropractor | Past | Accepting new patients |
| Cannon & Rutkoski Chiropractic, a Professional Corporation | Chiropractor | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- San Diego, CA
- NPI 1417222506
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260316800000",
"number": "1518296227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3503 4TH AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921034912",
"telephone_number": "619-501-7873",
"fax_number": "619-501-7883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3503 4TH AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921034912",
"telephone_number": "619-501-7873",
"fax_number": "619-501-7883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTKOSKI",
"first_name": "ALISSA",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-09",
"last_updated": "2009-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "30407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.