Scott David Nissenbaum, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC-31093 Issued in CA

Practice address

1100 Laurel St Ste D
San Carlos, CA 94070-5000

Phone

(415) 302-9007

Fax

(650) 666-6747

NPI assigned

Dec 17, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr. Scott Nissenbaum Chiropractic LLC

  • Chiropractor
  • San Carlos, CA
  • NPI 1104286368
  NPD Authorized official
• Perfectly Aligned Wellness, a Nissenbaum Chiropractic PC

  • Chiropractor
  • San Carlos, CA
  • NPI 1154909794
  NPD Authorized official

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

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1851694541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LAUREL ST STE D",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940705000",
            "telephone_number": "415-302-9007",
            "fax_number": "650-666-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAUREL ST STE D",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940705000",
            "telephone_number": "415-302-9007",
            "fax_number": "650-666-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSENBAUM",
        "first_name": "SCOTT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-17",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-31093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Nguyen
• Jeanny Nguyen, PHARMD
• Mary Lee Nickel, L.AC.
• Elizabeth Anne Nielsen, M.A., MFT
• Ninh Huy Tran, M.D., Inc.
• Ralph Charles Notor, MFT
• Aniekan Nwabuebo, DPT
• Sandra Nyholm Goncalves
• Melinda O'Neil, MA, APCC
• Derek Y. Obayashi, M.D.

• Chiropractor in San Carlos, CA
• Providers in San Carlos, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.