Gregg S Mallett, DC, ATC, CKTP

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

30918 Issued in CA

Practice address

22661 Lambert St
Suite 207
Lake Forest, CA 92630-1612

Phone

(949) 916-9742

Fax

(949) 716-2694

NPI assigned

Mar 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jennifer J Bak DC PC

  • Chiropractor
  • Wakefield, MA
  • NPI 1609944370
  NPD (past)
• New Beginnings Family Chiropractic Center LLC

  • Health Maintenance Organization
  • Wakefield, MA
  • NPI 1942636576
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362096000000",
    "number": "1902939648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22661 LAMBERT ST",
            "address_2": "SUITE 207",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301612",
            "telephone_number": "949-916-9742",
            "fax_number": "949-716-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22661 LAMBERT ST",
            "address_2": "SUITE 207",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301612",
            "telephone_number": "949-916-9742",
            "fax_number": "949-716-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLETT",
        "first_name": "GREGG",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DC, ATC, CKTP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2013-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2812",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "CA",
            "license": "30918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahroo Dental Corporation
• Nazafarine Mahroo, DDS
• Nicole Majowicz, FNP-BC
• Alya Makarem
• Celeste Maldonado
• Elena Malone
• Mammoth Path Solution LLC
• Mammoth Path Solution, LLC
• Katty Mirella Mancia, OTR/L
• Elizabeth Elaine Mann

• Orthopedic Chiropractor in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Orthopedic Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.