Individual provider Active NPI

Mahmood Moayed Makooi, DC, CCSP

  • Sports Physician Chiropractor
  • Vallejo, CA
National Provider Identifier
1689789000
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
3115 Issued in CA
Practice address
2121 Redwood St
Suite G
Vallejo, CA 94590-3603
Phone
(707) 644-8480
Fax
(707) 644-3926
NPI assigned
Aug 19, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 21746 CA
Sports Physician Chiropractor 111NS0005X 3115 CA Primary

Addresses

Primary practice location

2121 Redwood St
Suite G
Vallejo, CA 94590-3603

Mailing address

2121 Redwood St
Suite G
Vallejo, CA 94590-3603
Phone (707) 644-8480

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
21746CAMDChiropractor
3115CAMDSports Physician Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1689789000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 REDWOOD ST",
            "address_2": "SUITE G",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945903603",
            "telephone_number": "707-644-8480",
            "fax_number": "707-644-3926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 REDWOOD ST",
            "address_2": "SUITE G",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945903603",
            "telephone_number": "707-644-8480",
            "fax_number": "707-644-3926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKOOI",
        "first_name": "MAHMOOD",
        "middle_name": "MOAYED",
        "credential": "DC, CCSP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "21746",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "3115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.