Individual provider Active NPI

Robert Bruce Reynoso, D.C.

  • Chiropractor
  • Huntington Beach, CA
National Provider Identifier
1568640399
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC23961 Issued in CA
Practice address
8941 Adams Ave
Huntington Beach, CA 92646-3330
Phone
(714) 962-8818
Fax
(714) 962-8819
NPI assigned
Feb 4, 2008
Last updated
Nov 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC23961 CA Primary

Addresses

Primary practice location

8941 Adams Ave
Huntington Beach, CA 92646-3330

Mailing address

8941 Adams Ave
Huntington Beach, CA 92646-3330
Phone (714) 962-8818

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050813000155 CA Practitioner - Chiropractic 4082640487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reynoso Bruce Chiropractic CorpGroup PAC ID 4789878208, 2 clinicians

Practice addresses (Care Compare)

8941 Adams Ave
Huntington Beach, CA 92646-3330
Phone (714) 962-8818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC23961CAMDChiropractor
23961CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Reynoso-Bruce Chiropractic Corp Chiropractor CurrentSince Jul 31, 2010 Accepting new patients
Beach Pro Physical Medicine, Inc CurrentSince Dec 1, 2020 Accepting new patients

Locations

8873 Adams Ave
Huntington Beach, CA 92646
Phone (714) 600-1758

8941 Adams Ave
Huntington Beach, CA 92646
Phone (714) 600-1758

Organizations & group practices 4

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": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1568640399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8941 ADAMS AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926463330",
            "telephone_number": "714-962-8818",
            "fax_number": "714-962-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8941 ADAMS AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926463330",
            "telephone_number": "714-962-8818",
            "fax_number": "714-962-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOSO",
        "first_name": "ROBERT",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-04",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC23961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.