Active NPI
Rafael Blanco, DC
- Chiropractor
- San Diego, CA
National Provider Identifier
1841901196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 36496
- Practice address
- 8555 Station Village LN Ste B
San Diego, CA 92108-6567 - Phone
- (619) 486-3044
- NPI assigned
- Dec 7, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 36496 | CA | Primary |
Addresses
Primary practice location
8555 Station Village LN Ste B
San Diego, CA 92108-6567
Mailing address
1710 Avenida del Mundo Unit 504
Coronado, CA 92118-3065
Phone (619) 874-5607
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36496 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670371200000",
"number": "1841901196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1710 AVENIDA DEL MUNDO UNIT 504",
"city": "CORONADO",
"state": "CA",
"postal_code": "921183065",
"telephone_number": "619-874-5607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8555 STATION VILLAGE LN STE B",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921086567",
"telephone_number": "619-486-3044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANCO",
"first_name": "RAFAEL",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-07",
"last_updated": "2022-12-07",
"certification_date": "2022-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "36496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.