Individual provider Active NPI

Gregory Brent Knobbe, D.C,

  • Sports Physician Chiropractor
  • Fountain Valley, CA
National Provider Identifier
1669668711
Registry record updated Sep 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC23032 Issued in CA
Practice address
10101 Slater Ave
Suite 216
Fountain Valley, CA 92708-4733
Phone
(714) 962-9767
Fax
(714) 218-6924
NPI assigned
Sep 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X DC23032 CA Primary

Addresses

Primary practice location

10101 Slater Ave
Suite 216
Fountain Valley, CA 92708-4733

Mailing address

10101 Slater Ave
Suite 216
Fountain Valley, CA 92708-4733
Phone (714) 962-9767

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
DC23032CAMDSports Physician Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1190419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190419200000",
    "number": "1669668711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 SLATER AVE",
            "address_2": "SUITE 216",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084733",
            "telephone_number": "714-962-9767",
            "fax_number": "714-218-6924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 SLATER AVE",
            "address_2": "SUITE 216",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084733",
            "telephone_number": "714-962-9767",
            "fax_number": "714-218-6924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOBBE",
        "first_name": "GREGORY",
        "middle_name": "BRENT",
        "credential": "D.C,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-22",
        "last_updated": "2007-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC23032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.