Jesper Lundbaek, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CA22400 Issued in CA

Practice address

591 Redwood Highway
Suite 2300 Mill Valley Family Chiropractic
Mill Valley, CA 94941

Phone

(415) 389-9000

Fax

(415) 389-7912

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 1992

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mill Valley Family Chiropractic

  • Health Service Clinic/Center
  • Mill Valley, CA
  • NPI 1043433063
  NPD (past) Authorized official
• Resolution Pain Relief

  • Chiropractor
  • Mill Valley, CA
  • NPI 1174874929
  NPD (past) Authorized official

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1790881670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 REDWOOD HIGHWAY",
            "address_2": "SUITE 2300 MILL VALLEY FAMILY CHIROPRACTIC",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "94941",
            "telephone_number": "415-389-9000",
            "fax_number": "415-389-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 REDWOOD HIGHWAY",
            "address_2": "SUITE 2300 MILL VALLEY FAMILY CHIROPRACTIC",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "94941",
            "telephone_number": "415-389-9000",
            "fax_number": "415-389-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDBAEK",
        "first_name": "JESPER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "CA22400",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "HI664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Louis Lowe, M.D.
• Stefan Eric Lowenstein, MD
• Sarah Stark Lowenthal, M.D.
• Tabitha Ann Lowry, ND
• Tiffany Wai Ying Luk
• Sheila Francis Lynch
• C Samantha Lyons, LAC 1060
• Veronica Hiu Wai Ma
• Tenning Maa, RPH
• Ian Macintosh

• Chiropractor in Mill Valley, CA
• Providers in Mill Valley, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; 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.