R Tyler Johnson Chiropractic Professional Corporation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

DC30699 Issued in CA

Legal business name

R TYLER JOHNSON CHIROPRACTIC PROFESSIONAL CORPORATION

Practice address

83 Via Pico PLZ
San Clemente, CA 92672-3998

Phone

(949) 436-6440

NPI assigned

Apr 8, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Raymon Tyler Johnson, D.C.NPI 1639359763

Title

President

Phone

(949) 436-6440

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raymon Tyler Johnson, D.C.

  • Chiropractor
  • San Clemente, CA
  • NPI 1639359763
  Medicare reassignment Authorized official
• Stephanie Chen Glover, DC

  • Chiropractor
  • Costa Mesa, CA
  • NPI 1801398466
  NPD (past)

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1588083489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 VIA PICO PLZ",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723998",
            "telephone_number": "949-436-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 VIA PICO PLZ",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723998",
            "telephone_number": "949-436-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R TYLER JOHNSON CHIROPRACTIC PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-08",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RAYMON",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-436-6440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "DC30699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Pulone, SLPA
• Pure Life Recovery
• Rosalyn Quan, PHARMD
• Patrick Brian Quill, SOIDC
• R & K Lombard Pharmacy Corp.
• Janice Marie Rabel, L.C.S.W.
• Rachel Daggett Family Therapy, a Professional Corporation
• Philip Andrew Radovic, DPM
• Diane G. Rafferty, RN
• Andrea Ruth Raftery, P.T.

• Clinic/Center in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.