Organization Active NPI

Manibog Chiropractic Center Inc

  • Chiropractor
  • San Leandro, CA
National Provider Identifier
1790864841
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC25081 Issued in CA
Legal business name
MANIBOG CHIROPRACTIC CENTER INC
Practice address
369 Juana Ave
San Leandro, CA 94577-4810
Phone
(510) 357-1351
Fax
(510) 357-1365
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Authorized official

Name
Maria Manibog, DC
Title
President
Phone
(510) 357-1351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC25081 CA Primary

Addresses

Primary practice location

369 Juana Ave
San Leandro, CA 94577-4810

Mailing address

369 Juana Ave
San Leandro, CA 94577-4810
Phone (510) 357-1351

Other identifiers 1

IdentifierTypeStateIssuer
DC0250810OtherCABLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

369 Juana Ave
San Leandro, CA 94577
Phone (510) 316-3917

Practitioners & affiliated clinicians

Practitioners 4

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": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1790864841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 JUANA AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774810",
            "telephone_number": "510-357-1351",
            "fax_number": "510-357-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 JUANA AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774810",
            "telephone_number": "510-357-1351",
            "fax_number": "510-357-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANIBOG CHIROPRACTIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "MANIBOG",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-357-1351",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "DC0250810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.