Active NPI
Susan N Bobak, D.C.
- Nutrition Chiropractor
- Covina, CA
National Provider Identifier
1538194907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Chiropractor
- License
- 14830
- Practice address
- 646 S Eremland Dr
Covina, CA 91723-3523 - Phone
- (626) 859-6480
- Fax
- (626) 859-6482
- NPI assigned
- Jul 12, 2006
- 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 |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | 14830 | CA | Primary |
Addresses
Primary practice location
646 S Eremland Dr
Covina, CA 91723-3523
Mailing address
646 S Eremland Dr
Covina, CA 91723-3523
Phone (626) 859-6480
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 |
|---|---|---|---|
| 14830 | CA | MD | Developmental - Behavioral Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1538194907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "646 S EREMLAND DR",
"city": "COVINA",
"state": "CA",
"postal_code": "917233523",
"telephone_number": "626-859-6480",
"fax_number": "626-859-6482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "646 S EREMLAND DR",
"city": "COVINA",
"state": "CA",
"postal_code": "917233523",
"telephone_number": "626-859-6480",
"fax_number": "626-859-6482"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOBAK",
"first_name": "SUSAN",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "CA",
"license": "14830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covina, 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.