Marine Therapeutic

Primary specialty

Independent Medical Examiner ChiropractorTaxonomy code 111NI0013X

License

DC26457 Issued in CA

Legal business name

MARINE THERAPEUTIC

Practice address

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

Phone

(310) 519-1557

Fax

(310) 519-0330

NPI assigned

May 18, 2010

Last updated

May 18, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Karen Leyva

Title

Owner

Phone

(310) 519-1557

Specialties & licenses 2

Addresses

Practitioners 2

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.

• John A Nicola, DC

  • Chiropractor
  • Carson, CA
  • NPI 1477632644
  NPD (past)
• Sidney Yadidi, DC

  • Chiropractor
  • Santa Monica, CA
  • NPI 1942592811
  NPD (past)

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

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274140800000",
    "number": "1841519717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 W 9TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313601",
            "telephone_number": "310-519-1557",
            "fax_number": "310-519-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 W 9TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313601",
            "telephone_number": "310-519-1557",
            "fax_number": "310-519-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINE THERAPEUTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-18",
        "last_updated": "2010-05-18",
        "status": "A",
        "authorized_official_last_name": "LEYVA",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-519-1557"
    },
    "taxonomies": [
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "CA",
            "license": "DC13627",
            "primary": false
        },
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "CA",
            "license": "DC26457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ra'Vonne Mandac
• Staicy Maravillas
• Vincent Matthew Mardesich, DDS.
• Marisa Mares, PH.D.
• Maria Elena Newcomer DDS Inc
• Yvonne Marinkovich, D.C.
• Mark Perez , M.D.
• Mark Perez MD
• Donna Revae Mark
• Lawrence Marshall, O.D.

• Independent Medical Examiner Chiropractor in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Independent Medical Examiner Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; 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.