Organization Active NPI

Da Molthen JP Earnest Doctors of Chiropractic Apc

  • Chiropractor
  • Tustin, CA
National Provider Identifier
1689691511
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 8967 Issued in CA
Legal business name
DA MOLTHEN JP EARNEST DOCTORS OF CHIROPRACTIC APC
Practice address
14742 Plaza Dr
Ste 101
Tustin, CA 92780
Phone
(714) 838-1255
Fax
(714) 838-5784
NPI assigned
Jul 16, 2006
Last updated
May 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Authorized official

Name
John P Earnst, DC
Title
Vice President
Phone
(714) 838-1255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X DC 8967 CA Primary

Addresses

Primary practice location

14742 Plaza Dr
Ste 101
Tustin, CA 92780

Mailing address

14742 Plaza Dr
Ste 101
Tustin, CA 92780
Phone (714) 838-1255

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ77122ZOtherCABLUE SHIELD

Other names 1

  • DA Molthen JP Earnest TW Tucker Doctors of Chiropractic Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081229000611 CA Part B Supplier - Clinic/Group Practice 7113089186 Receives reassigned benefits from 2 practitioners
Practice locations: Tustin, CA

National Provider Directory

National Provider Directory

Locations

1950 S Brea Canyon Rd
Ste 6
Diamond Bar, CA 91765
Phone (909) 612-1060

14742 Plaza Dr
Ste 203
Tustin, CA 92780
Phone (714) 838-1255

14742 Plaza Dr
Ste 101
Tustin, CA 92780
Phone (714) 838-1255

14742 Plaza Dr
#101
Tustin, CA 92780
Phone (714) 838-1255

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1689691511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14742 PLAZA DR",
            "address_2": "STE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "92780",
            "telephone_number": "714-838-1255",
            "fax_number": "714-838-5784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14742 PLAZA DR",
            "address_2": "STE 101",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "92780",
            "telephone_number": "714-838-1255",
            "fax_number": "714-838-5784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DA MOLTHEN JP EARNEST DOCTORS OF CHIROPRACTIC APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "EARNST",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "714-838-1255",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 8967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ77122Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DA Molthen JP Earnest TW Tucker Doctors of Chiropractic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.