Individual provider Active NPI

David Y. Pessaran, B.A., D.C., Q.M.E.

  • Chiropractor
  • Citrus Heights, CA
National Provider Identifier
1649347089
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 14466 Issued in CA
Practice address
6830 Antelope Rd
Suite J
Citrus Heights, CA 95621-1977
Phone
(916) 723-8272
Fax
(916) 723-0688
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 14466 CA Primary

Addresses

Primary practice location

6830 Antelope Rd
Suite J
Citrus Heights, CA 95621-1977

Mailing address

6830 Antelope Rd
Suite J
Citrus Heights, CA 95621-1977
Phone (916) 723-8272

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
DC 14466CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1649347089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6830 ANTELOPE RD",
            "address_2": "SUITE J",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956211977",
            "telephone_number": "916-723-8272",
            "fax_number": "916-723-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6830 ANTELOPE RD",
            "address_2": "SUITE J",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956211977",
            "telephone_number": "916-723-8272",
            "fax_number": "916-723-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESSARAN",
        "first_name": "DAVID",
        "middle_name": "Y.",
        "name_prefix": "Dr.",
        "credential": "B.A., D.C., Q.M.E.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 14466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

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

Verify at the official NPI Registry.