NPIMap

Organization Active NPI

Il Hwan Park Chiropractic Clinic

  • Chiropractor
  • San Jose, CA
National Provider Identifier
1780069187
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC31167 Issued in CA
Legal business name
IL HWAN PARK CHIROPRACTIC CLINIC
Doing business as
BEST SPINE CHIROPRACTIC CLINIC
Practice address
4155 Moorpark Avenue
Suite 1
San Jose, CA 95117
Phone
(408) 249-0422
Fax
(408) 249-0430
NPI assigned
Jul 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Authorized official

Name
Ms. Tina Pham
Title
Administrator
Phone
(408) 249-0422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC31167 CA Primary

Addresses

Primary practice location

4155 Moorpark Avenue
Suite 1
San Jose, CA 95117

Mailing address

4155 Moorpark Avenue
Suite 1
San Jose, CA 95117
Phone (408) 249-0422

Other identifiers 2

IdentifierTypeStateIssuer
CA123188OtherCAPTAN
CA123187OtherCAMEDICARE PTAN

Other names 1

  • BEST SPINE CHIROPRACTIC CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Best Spine Chiropractic Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437955200000",
    "number": "1780069187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 MOORPARK AVENUE",
            "address_2": "SUITE 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95117",
            "telephone_number": "408-249-0422",
            "fax_number": "408-249-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 MOORPARK AVENUE",
            "address_2": "SUITE 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95117",
            "telephone_number": "408-249-0422",
            "fax_number": "408-249-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IL HWAN PARK CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-27",
        "last_updated": "2015-07-27",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "408-249-0422",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC31167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "CA123188",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CA123187",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEST SPINE CHIROPRACTIC CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; 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.