Organization Active NPI

Fernandez Chiropractic Corporation

  • Chiropractor
  • Valley Village, CA
National Provider Identifier
1861629644
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-27059 Issued in CA
Legal business name
FERNANDEZ CHIROPRACTIC CORPORATION
Practice address
12030 Riverside Dr
Valley Village, CA 91607-3749
Phone
(818) 985-2559
Fax
(818) 985-4459
NPI assigned
Jun 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Authorized official

Name
Dr. Antonio Fernandez IV, D.C.NPI 1013919000
Title
Ceo
Phone
(323) 203-1800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC-27059 CA Primary

Addresses

Primary practice location

12030 Riverside Dr
Valley Village, CA 91607-3749

Mailing address

12030 Riverside Dr
Valley Village, CA 91607-3749
Phone (818) 985-2559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210309002905 CA Part B Supplier - Clinic/Group Practice 0345656716 Receives reassigned benefits from 1 practitioner
Practice locations: Valley Village, CA

National Provider Directory

National Provider Directory

Locations

12030 Riverside Dr
Valley Vlg, CA 91607
Phone (818) 285-4242

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779840000000",
    "number": "1861629644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12030 RIVERSIDE DR",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073749",
            "telephone_number": "818-985-2559",
            "fax_number": "818-985-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12030 RIVERSIDE DR",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073749",
            "telephone_number": "818-985-2559",
            "fax_number": "818-985-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERNANDEZ CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-18",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-203-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-27059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.