Organization Active NPI

Khalsa Chiropractic a Professional Corporation

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1629269386
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12734 Issued in CA
Legal business name
KHALSA CHIROPRACTIC A PROFESSIONAL CORPORATION
Practice address
5880 San Vicente Blvd
Suite 101
Los Angeles, CA 90019-6627
Phone
(323) 857-1277
Fax
(323) 857-1574
NPI assigned
Aug 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Authorized official

Name
Dr. Mha Atma S Khalsa, D.C.NPI 1063429439
Title
President
Phone
(323) 857-1277

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 12734 CA Primary

Addresses

Primary practice location

5880 San Vicente Blvd
Suite 101
Los Angeles, CA 90019-6627

Mailing address

5880 San Vicente Blvd
Suite 101
Los Angeles, CA 90019-6627
Phone (323) 857-1277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071221000330 CA Part B Supplier - Clinic/Group Practice 9638269095 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

5880 San Vicente Blvd
Ste 101
Los Angeles, CA 90019
Phone (323) 857-1277

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": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1629269386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 SAN VICENTE BLVD",
            "address_2": "SUITE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900196627",
            "telephone_number": "323-857-1277",
            "fax_number": "323-857-1574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 SAN VICENTE BLVD",
            "address_2": "SUITE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900196627",
            "telephone_number": "323-857-1277",
            "fax_number": "323-857-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHALSA CHIROPRACTIC A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "KHALSA",
        "authorized_official_first_name": "MHA ATMA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-857-1277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "12734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.