Form Function Inc

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

Organization subpart

No

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

Authorized official

Name

Nicholas Garcia, D.C.

Title

Owner/Chiropractor

Phone

(310) 528-6276

Specialties & licenses 1

Addresses

Locations

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": []
}

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• Chiropractor in Vista, CA
• Providers in Vista, CA by specialty
• Chiropractor in California

• 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.