Active NPI
Mamerto Agcaoili Estepa Jr., D.C.
- Chiropractor
- San Diego, CA
National Provider Identifier
1710258744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC32131
- Practice address
- 1452 University Ave
San Diego, CA 92103-3405 - Phone
- (619) 291-5433
- Fax
- (919) 209-3608
- NPI assigned
- Jan 23, 2012
- Last updated
- Aug 14, 2013
- 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 | DC32131 | CA | Primary |
Addresses
Primary practice location
1452 University Ave
San Diego, CA 92103-3405
Mailing address
1286 University Ave # 545
San Diego, CA 92103-3312
Phone (760) 456-9086
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
| License | State | Type | Specialty |
|---|---|---|---|
| DC32131 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Laura T. Sowers-Mokuahi DC, LLC | Chiropractor | Past | Accepting new patients |
| Gottlieb Chiropractic Inc | Chiropractor | Past | Accepting new patients |
| H G Heeder Chiropractic Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- San Diego, CA
- NPI 1043621873
-
dba Life Within Family Chiropractic
- Chiropractor
- San Diego, CA
- NPI 1588716153
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376438400000",
"number": "1710258744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1286 UNIVERSITY AVE # 545",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921033312",
"telephone_number": "760-456-9086",
"fax_number": "760-456-9086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1452 UNIVERSITY AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921033405",
"telephone_number": "619-291-5433",
"fax_number": "919-209-3608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTEPA",
"first_name": "MAMERTO",
"middle_name": "AGCAOILI",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-23",
"last_updated": "2013-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC32131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.