Individual provider Active NPI

Charles J Fulanovich, D.C.

  • Chiropractor
  • Palo Alto, CA
National Provider Identifier
1538217849
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11581 Issued in CA
Practice address
1691 El Camino Real
Suite 100
Palo Alto, CA 94306-1009
Phone
(650) 328-2100
Fax
(650) 328-2104
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11581 CA Primary

Addresses

Primary practice location

1691 El Camino Real
Suite 100
Palo Alto, CA 94306-1009

Mailing address

1691 El Camino Real
Suite 100
Palo Alto, CA 94306-1009
Phone (650) 328-2100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130821000864 CA Practitioner - Chiropractic 8325281496 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fulanovich and Seid Chiropractic Chiropractor CurrentSince Oct 28, 2012 Accepting new patients

Locations

1691 El Camino Real
Ste 100
Palo Alto, CA 94306
Phone (650) 328-2100

Organizations & group practices 1

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538217849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1691 EL CAMINO REAL",
            "address_2": "SUITE 100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061009",
            "telephone_number": "650-328-2100",
            "fax_number": "650-328-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1691 EL CAMINO REAL",
            "address_2": "SUITE 100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061009",
            "telephone_number": "650-328-2100",
            "fax_number": "650-328-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULANOVICH",
        "first_name": "CHARLES",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "11581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, 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.
  • 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.