Active NPI
Charles Phillip Gagarin, D.C.
- Chiropractor
- Carmel Valley, CA
National Provider Identifier
1619022720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC 13520
- Practice address
- 13766 Center St
Suite 211
Carmel Valley, CA 93924-9693 - Phone
- (831) 659-8009
- Fax
- (831) 659-8009
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC 13520 | CA | Primary |
Addresses
Primary practice location
13766 Center St
Suite 211
Carmel Valley, CA 93924-9693
Mailing address
13766 Center St
Suite 211
Carmel Valley, CA 93924-9693
Phone (831) 659-8009
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13520 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| DC 13520 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619022720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13766 CENTER ST",
"address_2": "SUITE 211",
"city": "CARMEL VALLEY",
"state": "CA",
"postal_code": "939249693",
"telephone_number": "831-659-8009",
"fax_number": "831-659-8009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13766 CENTER ST",
"address_2": "SUITE 211",
"city": "CARMEL VALLEY",
"state": "CA",
"postal_code": "939249693",
"telephone_number": "831-659-8009",
"fax_number": "831-659-8009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAGARIN",
"first_name": "CHARLES",
"middle_name": "PHILLIP",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC 13520",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carmel Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.