Organization Active NPI

Mark Gorbahn Chiropractic Inc.

  • Chiropractor
  • Atascadero, CA
National Provider Identifier
1750713996
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MARK GORBAHN CHIROPRACTIC INC.
Practice address
9455 El Camino Real
Atascadero, CA 93422-5513
Phone
(805) 466-5200
Fax
(805) 462-2489
NPI assigned
Jul 30, 2013
Last updated
Aug 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Authorized official

Name
Dr. Mark Kenneth Gorbahn, D.C.NPI 1619992815
Title
Doctor
Phone
(805) 466-5200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

9455 El Camino Real
Atascadero, CA 93422-5513

Mailing address

9455 El Camino Real
Atascadero, CA 93422-5513
Phone (805) 466-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130815000253 CA Part B Supplier - Clinic/Group Practice 9739321050 Receives reassigned benefits from 1 practitioner
Practice locations: Atascadero, CA

National Provider Directory

National Provider Directory

Locations

9455 El Camino Real
Atascadero, CA 93422
Phone (805) 466-5200

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1750713996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9455 EL CAMINO REAL",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225513",
            "telephone_number": "805-466-5200",
            "fax_number": "805-462-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9455 EL CAMINO REAL",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225513",
            "telephone_number": "805-466-5200",
            "fax_number": "805-462-2489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK GORBAHN CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-30",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A",
        "authorized_official_last_name": "GORBAHN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "805-466-5200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atascadero, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.