Michael Ken Stites, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

19295 Issued in CA

Practice address

2415 W Whittier Blvd
La Habra, CA 90631-3406

Phone

(562) 694-1125

Fax

(562) 690-3116

NPI assigned

Sep 3, 2008

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1861640971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15550 ROCKFIELD BLVD",
            "address_2": "B220",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182720",
            "telephone_number": "949-598-9999",
            "fax_number": "949-598-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 W WHITTIER BLVD",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906313406",
            "telephone_number": "562-694-1125",
            "fax_number": "562-690-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STITES",
        "first_name": "MICHAEL",
        "middle_name": "KEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "19295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "DC19295",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in La Habra, CA
• Providers in La Habra, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.