Individual provider Active NPI

Robert R. Rettig, D.C.

  • Chiropractor
  • Irvine, CA
National Provider Identifier
1649201278
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC18018 Issued in CA
Practice address
4330 Barranca Pkwy
Suite 150-B
Irvine, CA 92604-4755
Phone
(949) 559-7999
Fax
(949) 559-5582
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC18018 CA Primary

Addresses

Primary practice location

4330 Barranca Pkwy
Suite 150-B
Irvine, CA 92604-4755

Mailing address

4330 Barranca Parkway
Suite 150-B
Irvine, CA 92604
Phone (949) 559-7999

Other identifiers 1

IdentifierTypeStateIssuer
DC18018AOtherCAMEDICARE PTAN

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

State licenses

LicenseStateTypeSpecialty
DC18018CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gary R. Martin, D.C., Chiropractic Corporation Chiropractor PastSince Jan 1, 2025 Accepting new patients
Okouchi Chiropractic, Inc. Chiropractor Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1649201278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 BARRANCA PARKWAY",
            "address_2": "SUITE 150-B",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92604",
            "telephone_number": "949-559-7999",
            "fax_number": "949-559-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 BARRANCA PKWY",
            "address_2": "SUITE 150-B",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044755",
            "telephone_number": "949-559-7999",
            "fax_number": "949-559-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETTIG",
        "first_name": "ROBERT",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC18018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "DC18018A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.