Individual provider Active NPI

Sean Martin Braithwaite, D.C.

  • Chiropractor
  • Seal Beach, CA
National Provider Identifier
1902170434
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
32211 Issued in CA
Practice address
12501 Seal Beach Blvd
Suite 160
Seal Beach, CA 90740-2763
Phone
(562) 596-6000
Fax
(562) 596-6040
NPI assigned
Mar 1, 2012
Last updated
Apr 7, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 32211 CA Primary

Addresses

Primary practice location

12501 Seal Beach Blvd
Suite 160
Seal Beach, CA 90740-2763

Mailing address

6850 E Septimo St
Long Beach, CA 90815-5018
Phone (562) 522-1463

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221221000830 CA Practitioner - Chiropractic 8426427188 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32211CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Braithwaite Chiropractic, Inc. Chiropractor CurrentSince Nov 2, 2022 Accepting new patients

Locations

12501 Seal Beach Blvd
Ste 160
Seal Beach, CA 90740
Phone (562) 596-6000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1902170434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 E SEPTIMO ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908155018",
            "telephone_number": "562-522-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 SEAL BEACH BLVD",
            "address_2": "SUITE 160",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402763",
            "telephone_number": "562-596-6000",
            "fax_number": "562-596-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAITHWAITE",
        "first_name": "SEAN",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-01",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "32211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seal Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; 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.