Individual provider Active NPI

Thomas Y. Iwashita, DC

  • Chiropractor
  • Garden Grove, CA
National Provider Identifier
1669529244
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC27090 Issued in CA
Practice address
11562 Knott St Ste 17
Garden Grove, CA 92841-1823
Phone
(714) 209-7602
Fax
(714) 209-7465
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC27090 CA Primary

Addresses

Primary practice location

11562 Knott St Ste 17
Garden Grove, CA 92841-1823

Mailing address

11562 Knott St Ste 17
Garden Grove, CA 92841-1823
Phone (714) 209-7602

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC27090CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Iwashita Chiropractic Corp Chiropractor CurrentSince Feb 9, 2025 Accepting new patients
Rattray Chiropractic Corporation PastSince Jun 20, 2012 Accepting new patients

Locations

11562 Knott St
Ste 17
Garden Grove, CA 92841
Phone (714) 209-7602

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1669529244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11562 KNOTT ST STE 17",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928411823",
            "telephone_number": "714-209-7602",
            "fax_number": "714-209-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11562 KNOTT ST STE 17",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928411823",
            "telephone_number": "714-209-7602",
            "fax_number": "714-209-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWASHITA",
        "first_name": "THOMAS",
        "middle_name": "Y.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC27090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.