Individual provider Active NPI

Clifford C Oliver III, DC RN

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1720158256
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC14179 Issued in CA
Practice address
3737 Moraga Ave
Ste A102
San Diego, CA 92117
Phone
(858) 272-2333
Fax
(858) 272-2335
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC14179 CA Primary

Addresses

Primary practice location

3737 Moraga Ave
Ste A102
San Diego, CA 92117

Mailing address

3737 Moraga Ave
Ste A102
San Diego, CA 92117
Phone (858) 272-2333

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
DC14179CAMDChiropractor

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": "1318377600000",
    "number": "1720158256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVE",
            "address_2": "STE A102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92117",
            "telephone_number": "858-272-2333",
            "fax_number": "858-272-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVE",
            "address_2": "STE A102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92117",
            "telephone_number": "858-272-2333",
            "fax_number": "858-272-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "CLIFFORD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DC RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC14179",
            "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 Oct 12, 2011; 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.