NPIMap

Organization Active NPI

Form Function Inc

  • Chiropractor
  • Vista, CA
National Provider Identifier
1548758071
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FORM FUNCTION INC
Practice address
1966 Hacienda Dr
Vista, CA 92081-6025
Phone
(310) 528-6276
NPI assigned
Apr 30, 2018
Last updated
Apr 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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

Authorized official

Name
Nicholas Garcia, D.C.NPI 1194195537
Title
Owner/Chiropractor
Phone
(310) 528-6276

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1966 Hacienda Dr
Vista, CA 92081-6025

Mailing address

PO Box 1176
Cardiff, CA 92007-7176
Phone (858) 509-7999

National Provider Directory

National Provider Directory

Locations

1966 Hacienda Dr
Vista, CA 92081
Phone (310) 528-6276

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525046400000",
    "number": "1548758071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1176",
            "city": "CARDIFF",
            "state": "CA",
            "postal_code": "920077176",
            "telephone_number": "858-509-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1966 HACIENDA DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816025",
            "telephone_number": "310-528-6276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORM FUNCTION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-30",
        "last_updated": "2018-04-30",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "310-528-6276",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.