Organization Active NPI

Pourteymoor Chiropractic, a Professional Corporation

  • Chiropractor
  • San Pedro, CA
National Provider Identifier
1780921619
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
32034 Issued in CA
Legal business name
POURTEYMOOR CHIROPRACTIC, A PROFESSIONAL CORPORATION
Practice address
789 W 9TH St
San Pedro, CA 90731-3601
Phone
(310) 519-1557
NPI assigned
Jan 11, 2013
Last updated
Jan 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

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

Authorized official

Name
Dr. Nahdir Pourteymoor, D.C.NPI 1720361132
Title
Chiropractor-President
Phone
(909) 549-3535

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 32034 CA Primary

Addresses

Primary practice location

789 W 9TH St
San Pedro, CA 90731-3601

Mailing address

789 W 9TH St
San Pedro, CA 90731-3601

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130306000189 CA Part B Supplier - Clinic/Group Practice 7719132331 Receives reassigned benefits from 2 practitioners
Practice locations: San Pedro, CA

National Provider Directory

National Provider Directory

Locations

789 W 9th St
San Pedro, CA 90731
Phone (310) 519-1557

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357862400000",
    "number": "1780921619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 W 9TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 W 9TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313601",
            "telephone_number": "310-519-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POURTEYMOOR CHIROPRACTIC, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-11",
        "last_updated": "2013-01-11",
        "status": "A",
        "authorized_official_last_name": "POURTEYMOOR",
        "authorized_official_first_name": "NAHDIR",
        "authorized_official_title_or_position": "CHIROPRACTOR-PRESIDENT",
        "authorized_official_telephone_number": "909-549-3535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "32034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; 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.