Individual provider Active NPI

Xuan Diep, D.C.

  • Sports Physician Chiropractor
  • Los Angeles, CA
National Provider Identifier
1679720130
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC 28057 Issued in CA
Practice address
913 White Knoll Dr
Los Angeles, CA 90012-1312
Phone
(213) 482-4772
NPI assigned
Aug 26, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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 DC 28057 CA Primary

Addresses

Primary practice location

913 White Knoll Dr
Los Angeles, CA 90012-1312

Mailing address

913 White Knoll Dr
Los Angeles, CA 90012-1312
Phone (213) 482-4772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121008000216 CA Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 6305095381 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Physical Medicine and Rehabilitation
Education
Life Chiropractic College - West, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HD Physical Medicine a Professional Medical CorporationGroup PAC ID 3678974243, 10 clinicians

Practice addresses (Care Compare)

17330 Bear Valley Rd
Suite 105
Victorville, CA 92395-7741
Phone (760) 245-5182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 28057CAMDSports Physician Chiropractor
28057CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
HD Physical Medicine, a Professional Medical Corporation Sports Physician CurrentSince Feb 21, 2025 Accepting new patients
Donia Chiropractic, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Movement Evolved Physical Therapy P.C. PastSince Sep 14, 2025 Accepting new patients

Locations

1455 W Park Ave
Ste A
Redlands, CA 92373
Phone (909) 657-9652

17330 Bear Valley Rd
Ste 105
Victorville, CA 92395
Phone (760) 245-5182

Organizations & group practices 3

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": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1679720130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 WHITE KNOLL DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900121312",
            "telephone_number": "213-482-4772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 WHITE KNOLL DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900121312",
            "telephone_number": "213-482-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEP",
        "first_name": "XUAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-26",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC 28057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.