Individual provider Active NPI

Jose Hernandez, D.C.

  • Chiropractor
  • San Marcos, CA
National Provider Identifier
1720158140
Registry record updated Nov 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC28894 Issued in CA
Practice address
1125 Linda Vista Dr
Ste. 102
San Marcos, CA 92078-3819
Phone
(760) 591-4878
Fax
(760) 591-7878
NPI assigned
Nov 9, 2006
Last updated
Nov 14, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC28894 CA Primary

Addresses

Primary practice location

1125 Linda Vista Dr
Ste. 102
San Marcos, CA 92078-3819

Mailing address

1125 Linda Vista Dr
Ste. 102
San Marcos, CA 92078-3819
Phone (760) 591-4878

Other identifiers 1

IdentifierTypeStateIssuer
455620689OtherCANEW TAX IDENTIFICATION NUMBER

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
DC28894CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness First Chiropractic Chiropractor PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352851200000",
    "number": "1720158140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 LINDA VISTA DR",
            "address_2": "STE. 102",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920783819",
            "telephone_number": "760-591-4878",
            "fax_number": "760-591-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 LINDA VISTA DR",
            "address_2": "STE. 102",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920783819",
            "telephone_number": "760-591-4878",
            "fax_number": "760-591-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "JOSE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2012-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW TAX IDENTIFICATION NUMBER",
            "identifier": "455620689",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; 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.