Individual provider Active NPI

Chett Legrand Mallett, D.C.

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1780777003
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27812 Issued in CA
Practice address
3535 Cahuenga Blvd W Ste 206
Los Angeles, CA 90068-1359
Phone
(323) 968-3535
Fax
(323) 435-5138
NPI assigned
Sep 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 27812 CA Primary

Addresses

Primary practice location

3535 Cahuenga Blvd W Ste 206
Los Angeles, CA 90068-1359

Mailing address

3535 Cahuenga Blvd W Ste 206
Los Angeles, CA 90068-1359
Phone (323) 968-3535

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121129000604 CA Practitioner - Chiropractic 8224007299

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3535 Cahuenga Blvd W
Suite 206
Los Angeles, CA 90068-1359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27812CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Legrand Wellness Chiropractic PC Chiropractor Current Accepting new patients
Advanced Wellness Center, Inc Past Accepting new patients
Performance Spinal Care Chiropractor PastSince Nov 6, 2012 Accepting new patients

Locations

3535 Cahuenga Blvd W
Ste 206
Los Angeles, CA 90068
Phone (323) 600-4303

Organizations & group practices 3

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": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1780777003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 CAHUENGA BLVD W STE 206",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900681359",
            "telephone_number": "323-968-3535",
            "fax_number": "323-435-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 CAHUENGA BLVD W STE 206",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900681359",
            "telephone_number": "323-968-3535",
            "fax_number": "323-435-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLETT",
        "first_name": "CHETT",
        "middle_name": "LEGRAND",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "27812",
            "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 28, 2022; 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.