NPIMap

Organization Active NPI

Chan Chiropractic Inc

  • Multi-Specialty Clinic/Center
  • Berkeley, CA
National Provider Identifier
1598513145
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CHAN CHIROPRACTIC INC
Practice address
2459 Ashby Ave Ste B
Berkeley, CA 94705-2009
Phone
(510) 984-3348
Fax
(510) 256-0197
NPI assigned
May 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Authorized official

Name
Dr. Amanda L Chan, DCNPI 1952956336
Title
Owner
Phone
(774) 270-2199

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

2459 Ashby Ave Ste B
Berkeley, CA 94705-2009

Mailing address

2459 Ashby Ave Ste B
Berkeley, CA 94705-2009
Phone (510) 984-3348

Other practice location 1

1819 Houret Ct
Milpitas, CA 95035-6823
Phone (510) 984-3348

Other names 1

  • Flow State Chiropractic & Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260108002820 CA Part B Supplier - Clinic/Group Practice 0446736581 Receives reassigned benefits from 2 practitioners
Practice locations: Berkeley, CA

National Provider Directory

National Provider Directory

Locations

2459 Ashby Ave
Ste B
Berkeley, CA 94705
Phone (510) 984-3348

1819 Houret Ct
Milpitas, CA 95035
Phone (510) 984-3348

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1598513145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2459 ASHBY AVE STE B",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052009",
            "telephone_number": "510-984-3348",
            "fax_number": "510-256-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2459 ASHBY AVE STE B",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052009",
            "telephone_number": "510-984-3348",
            "fax_number": "510-256-0197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1819 Houret Ct",
            "address_purpose": "LOCATION",
            "city": "Milpitas",
            "state": "CA",
            "postal_code": "950356823",
            "country_code": "US",
            "telephone_number": "510-984-3348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHAN CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "774-270-2199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Flow State Chiropractic & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.