Organization Active NPI

Douglas Desalvo Chiropractic, Inc

  • Chiropractor
  • Novato, CA
National Provider Identifier
1922239904
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DOUGLAS DESALVO CHIROPRACTIC, INC
Practice address
7595 Redwood Blvd
Ste108
Novato, CA 94945-7700
Phone
(415) 898-6888
Fax
(415) 898-8474
NPI assigned
Aug 7, 2009
Last updated
Jun 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Authorized official

Name
Angela C Desalvo
Title
Manager
Phone
(415) 898-6888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

7595 Redwood Blvd
Ste108
Novato, CA 94945-7700

Mailing address

7595 Redwood Blvd
Ste108
Novato, CA 94945-7700
Phone (415) 898-6888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090911000069 CA Part B Supplier - Clinic/Group Practice 5698820819 Receives reassigned benefits from 1 practitioner
Practice locations: Novato, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1922239904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7595 REDWOOD BLVD",
            "address_2": "STE108",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949457700",
            "telephone_number": "415-898-6888",
            "fax_number": "415-898-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7595 REDWOOD BLVD",
            "address_2": "STE108",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949457700",
            "telephone_number": "415-898-6888",
            "fax_number": "415-898-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS DESALVO CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-07",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "DESALVO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "415-898-6888"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.