Active NPI
Thomas Jacob Vandusen
- Rehabilitation Chiropractor
- Mission Viejo, CA
National Provider Identifier
1780707455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- DC28755
- Practice address
- 24002 Via Fabricante Ste 501
Mission Viejo, CA 92691-3934 - Phone
- (949) 454-8811
- NPI assigned
- Apr 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | DC28755 | CA | Primary |
Addresses
Primary practice location
24002 Via Fabricante Ste 501
Mission Viejo, CA 92691-3934
Mailing address
24002 Via Fabricante Ste 501
Mission Viejo, CA 92691-3934
Phone (949) 454-8811
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC28755 | CA | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780707455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24002 VIA FABRICANTE STE 501",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926913934",
"telephone_number": "949-454-8811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24002 VIA FABRICANTE STE 501",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926913934",
"telephone_number": "949-454-8811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDUSEN",
"first_name": "THOMAS",
"middle_name": "JACOB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "CA",
"license": "DC28755",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission Viejo, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.