Individual provider Active NPI

Mitchell W Griner, D.C.

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1740357276
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC13786 Issued in CA
Practice address
11669 Santa Monica Blvd
Suite # 101
Los Angeles, CA 90025-2929
Phone
(310) 477-1749
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC13786 CA Primary

Addresses

Primary practice location

11669 Santa Monica Blvd
Suite # 101
Los Angeles, CA 90025-2929

Mailing address

11669 Santa Monica Blvd
Suite # 101
Los Angeles, CA 90025-2929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120208000940 CA Practitioner - Chiropractic 2163689795 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1980
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10513 Butterfield Rd
Los Angeles, CA 90064-4400
Phone (310) 477-1749

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC13786CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740357276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11669 SANTA MONICA BLVD",
            "address_2": "SUITE # 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11669 SANTA MONICA BLVD",
            "address_2": "SUITE # 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252929",
            "telephone_number": "310-477-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINER",
        "first_name": "MITCHELL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC13786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.