Fontana Chiropractic and Acupuncture

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

33617 Issued in CA

Legal business name

FONTANA CHIROPRACTIC AND ACUPUNCTURE

Practice address

13677 Foothill Blvd
Ste P
Fontana, CA 92335-0505

Phone

(909) 766-5397

Fax

(909) 697-2274

NPI assigned

Sep 14, 2016

Organization subpart

No

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

Authorized official

Name

Michael Mark, LA.CNPI 1508310244

Title

Co-Owner/Acupuncturist

Phone

(909) 766-5397

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael David Mark, LA.C, DIPL. O.M.

  • Acupuncturist
  • Fontana, CA
  • NPI 1508310244
  NPD Authorized official
• Marissa Palmer, D.C.

  • Chiropractor
  • Fontana, CA
  • NPI 1326491457
  Medicare reassignment

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1700334166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20687 AMAR RD",
            "address_2": "STE 2, BOX 240",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917895044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13677 FOOTHILL BLVD",
            "address_2": "STE P",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923350505",
            "telephone_number": "909-766-5397",
            "fax_number": "909-697-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FONTANA CHIROPRACTIC AND ACUPUNCTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-14",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "MARK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CO-OWNER/ACUPUNCTURIST",
        "authorized_official_telephone_number": "909-766-5397",
        "authorized_official_credential": "LA.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33617",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "17044",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashanique Foncham
• Elizabeth E Fong, PHARM D
• Li Ming Fong
• Shirley Fong, MD
• Fontana Artificial Limb & Brace Inc.
• Fontana Dental Clinic
• Fontana Family Acupuncture Inc.
• Fontana Healthcare, LLC
• Fontana Modern Dentistry, Inc
• Fontana Optometric Group, Inc.

• Chiropractor in Fontana, CA
• Providers in Fontana, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; 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.