Individual provider Active NPI

Craig M Petersen, D.C.

  • Chiropractor
  • Laguna Hills, CA
National Provider Identifier
1760697262
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC25168 Issued in CA
Practice address
25401 Cabot Rd Ste 112
Laguna Hills, CA 92653-5513
Phone
(949) 388-1432
Fax
(949) 388-1434
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC25168 CA Primary

Addresses

Primary practice location

25401 Cabot Rd Ste 112
Laguna Hills, CA 92653-5513

Mailing address

31734 Rancho Viejo Rd
Suite C
San Juan Capistrano, CA 92675-2782
Phone (949) 388-1432

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090625000284 CA Practitioner - Chiropractic 0244381671 Practice locations: Laguna Hills, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

25401 Cabot Rd
Suite 112
Laguna Hills, CA 92653-5513
Phone (949) 388-1432

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC25168CAMDChiropractor
25168CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Chiropractic, a Rundle Corporation Chiropractor CurrentSince Jun 23, 2025 Accepting new patients
Foudy Chiropractic Inc Chiropractor Past Accepting new patients

Locations

25401 Cabot Rd
Ste 112
Laguna Hills, CA 92653
Phone (949) 388-1432

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1760697262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31734 RANCHO VIEJO RD",
            "address_2": "SUITE C",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752782",
            "telephone_number": "949-388-1432",
            "fax_number": "949-388-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25401 CABOT RD STE 112",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535513",
            "telephone_number": "949-388-1432",
            "fax_number": "949-388-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "CRAIG",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.