Active NPI
Marilyn Ida Carmona, DC
- Orthopedic Chiropractor
- San Mateo, CA
National Provider Identifier
1811917099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Chiropractor
- License
- 15160
- Practice address
- 1407 S B St
Ste #3
San Mateo, CA 94402-2433 - Phone
- (650) 342-3452
- Fax
- (650) 342-4087
- NPI assigned
- Jul 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Chiropractor | 111NX0800X | 15160 | CA | Primary |
Addresses
Primary practice location
1407 S B St
Ste #3
San Mateo, CA 94402-2433
Mailing address
1407 S B St
Ste #3
San Mateo, CA 94402-2433
Phone (650) 342-3452
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15160 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spicereddy Chiropractic, Inc | Past | Accepting new patients | |
| Fung Chiropractic | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Chiropractor
- San Mateo, CA
- NPI 1619053634
-
- Chiropractor
- San Mateo, CA
- NPI 1679020432
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483056000000",
"number": "1811917099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1407 S B ST",
"address_2": "STE #3",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944022433",
"telephone_number": "650-342-3452",
"fax_number": "650-342-4087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1407 S B ST",
"address_2": "STE #3",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944022433",
"telephone_number": "650-342-3452",
"fax_number": "650-342-4087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARMONA",
"first_name": "MARILYN",
"middle_name": "IDA",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-20",
"last_updated": "2016-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "111NX0800X",
"taxonomy_group": "",
"desc": "Chiropractor, Orthopedic",
"state": "CA",
"license": "15160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.