Organization Active NPI

Guedea Chiropractic, Inc.

  • Chiropractor
  • San Pedro, CA
National Provider Identifier
1609416635
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GUEDEA CHIROPRACTIC, INC.
Practice address
302 W 5TH St Ste 101
San Pedro, CA 90731-2700
Phone
(310) 732-0029
Fax
(310) 732-0039
NPI assigned
Jan 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Authorized official

Name
Miguel Antonio Guedea, DCNPI 1215235577
Title
Chiropractor
Phone
(805) 317-3053

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

302 W 5TH St Ste 101
San Pedro, CA 90731-2700

Mailing address

302 W 5TH St Ste 101
San Pedro, CA 90731-2700
Phone (310) 732-0029

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200221002002 CA Part B Supplier - Clinic/Group Practice 2466889951 Receives reassigned benefits from 1 practitioner
Practice locations: San Pedro, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1578355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1609416635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W 5TH ST STE 101",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312700",
            "telephone_number": "310-732-0029",
            "fax_number": "310-732-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W 5TH ST STE 101",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312700",
            "telephone_number": "310-732-0029",
            "fax_number": "310-732-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUEDEA CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "GUEDEA",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "805-317-3053",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.