Organization Active NPI

Michelle Leach Chiropractic Corp

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1780852574
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC272540 Issued in CA
Legal business name
MICHELLE LEACH CHIROPRACTIC CORP
Practice address
9474 Kearny Villa Road
#113
San Diego, CA 92126
Phone
(858) 578-2070
Fax
(858) 578-2722
NPI assigned
Feb 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Dr. Michelle L Leach, DCNPI 1679642771
Title
Chiropractor
Phone
(858) 578-2070

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC272540 CA Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC 11426 CA

Addresses

Primary practice location

9474 Kearny Villa Road
#113
San Diego, CA 92126

Mailing address

9474 Kearny Villa Road
#113
San Diego, CA 92126
Phone (858) 578-2070

Other identifiers 1

IdentifierTypeStateIssuer
DC0272540OtherCABLUESHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080602000412 CA Part B Supplier - Clinic/Group Practice 9133299241 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

9474 Kearny Villa Rd
Ste 113
San Diego, CA 92126
Phone (858) 578-2070

Practitioners & affiliated clinicians

Practitioners 2

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": "1202947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1780852574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9474 KEARNY VILLA ROAD",
            "address_2": "#113",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92126",
            "telephone_number": "858-578-2070",
            "fax_number": "858-578-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9474 KEARNY VILLA ROAD",
            "address_2": "#113",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92126",
            "telephone_number": "858-578-2070",
            "fax_number": "858-578-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE LEACH CHIROPRACTIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-14",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "858-578-2070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC272540",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 11426",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "DC0272540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.