Individual provider Active NPI

Matt Alavi

  • Acupuncturist
  • Poway, CA
National Provider Identifier
1558567313
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
10549 Issued in CA
Practice address
15611 Pomerado Road
Suite 100 South
Poway, CA 92064
Phone
(858) 673-4400
Fax
(858) 673-4499
NPI assigned
Jun 26, 2007
Last updated
Sep 16, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 10549 CA Primary

Addresses

Primary practice location

15611 Pomerado Road
Suite 100 South
Poway, CA 92064

Mailing address

15611 Pomerado Road
Suite 100 South
Poway, CA 92064
Phone (858) 673-4400

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
10549CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Activemed Integrative Health Center Acupuncturist CurrentSince Jul 26, 2021 Accepting new patients

Locations

317 N El Camino Real
Ste 306
Encinitas, CA 92024
Phone (760) 458-1600

15611 Pomerado Rd
Ste 100
Poway, CA 92064
Phone (858) 613-6110

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1558567313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15611 POMERADO ROAD",
            "address_2": "SUITE 100 SOUTH",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "92064",
            "telephone_number": "858-673-4400",
            "fax_number": "858-673-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15611 POMERADO ROAD",
            "address_2": "SUITE 100 SOUTH",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "92064",
            "telephone_number": "858-673-4400",
            "fax_number": "858-673-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAVI",
        "first_name": "MATT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "10549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.