Individual provider Active NPI

Spencer Hung Wo Yim Shimabukuro, D.C.

  • Chiropractor
  • El Segundo, CA
National Provider Identifier
1891088795
Registry record updated May 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 31999 Issued in CA
Practice address
100 W Imperial Ave
Suite N
El Segundo, CA 90245-2200
Phone
(310) 322-1757
Fax
(310) 322-1767
NPI assigned
May 25, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 31999 CA Primary

Addresses

Primary practice location

100 W Imperial Ave
Suite N
El Segundo, CA 90245-2200

Mailing address

100 W Imperial Ave
Suite N
El Segundo, CA 90245-2200
Phone (310) 322-1757

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

LicenseStateTypeSpecialty
DC 31999CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1891088795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W IMPERIAL AVE",
            "address_2": "SUITE N",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452200",
            "telephone_number": "310-322-1757",
            "fax_number": "310-322-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W IMPERIAL AVE",
            "address_2": "SUITE N",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452200",
            "telephone_number": "310-322-1757",
            "fax_number": "310-322-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMABUKURO",
        "first_name": "SPENCER",
        "middle_name": "HUNG WO YIM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-25",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 31999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; 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.