Jack Li, D.C., a Chiropractic Corporation

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

JACK LI, D.C., A CHIROPRACTIC CORPORATION

Practice address

12340 Santa Monica Blvd Ste 129
Los Angeles, CA 90025-2584

Phone

(310) 207-1007

Fax

(310) 633-8338

NPI assigned

Nov 18, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Jack T Li, DCNPI 1043450653

Title

President

Phone

(310) 207-1007

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.

• Jack Thomas Li, D.C.

  • Chiropractor
  • Los Angeles, CA
  • NPI 1043450653
  Medicare reassignment NPD Authorized official
• Jingyan Ren

  • Acupuncturist
  • Eastvale, CA
  • NPI 1649838145
  NPD (past)

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574035200000",
    "number": "1639715352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12340 SANTA MONICA BLVD STE 129",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252584",
            "telephone_number": "310-207-1007",
            "fax_number": "310-633-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12340 SANTA MONICA BLVD STE 129",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252584",
            "telephone_number": "310-207-1007",
            "fax_number": "310-633-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK LI, D.C., A CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-207-1007",
        "authorized_official_name_prefix": "Dr.",
        "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": []
}

• Nancy Jacinto
• Rudell Gary Santos Jacinto, D.M.D.
• Yobany Jacinto
• Jack Azad,M.D.,Inc.
• Jack Baum MD Inc
• Jack Rothberg MD a Medical Copt
• Jack S Kao MD Inc
• Jack Wax, M.D., Inc
• Caron Jack
• Katherine Wells Jack

• Chiropractor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.