Active NPI
John Waylan Blalock, D.C.
- Chiropractor
- El Segundo, CA
National Provider Identifier
1679963185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 33163
- Practice address
- 523 Main St
El Segundo, CA 90245-3006 - Phone
- (310) 322-0912
- Fax
- (310) 322-6872
- NPI assigned
- Feb 4, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 33163 | CA | Primary |
Addresses
Primary practice location
523 Main St
El Segundo, CA 90245-3006
Mailing address
523 Main St
El Segundo, CA 90245-3006
Phone (310) 322-0912
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423008000000",
"number": "1679963185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 MAIN ST",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902453006",
"telephone_number": "310-322-0912",
"fax_number": "310-322-6872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "523 MAIN ST",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902453006",
"telephone_number": "310-322-0912",
"fax_number": "310-322-6872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLALOCK",
"first_name": "JOHN",
"middle_name": "WAYLAN",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-04",
"last_updated": "2015-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "33163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Segundo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.