NPIMap

Organization Active NPI

Mullen Chiropractic Corporation

Doing business as The Good Life Chiropractic

  • Chiropractor
  • Berkeley, CA
National Provider Identifier
1932383569
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
25356 Issued in CA
Legal business name
MULLEN CHIROPRACTIC CORPORATION
Doing business as
The Good Life Chiropractic
Practice address
2620 Telegraph Ave
Berkeley, CA 94704-3321
Phone
(510) 356-4048
Fax
(510) 356-4137
NPI assigned
Dec 18, 2007
Last updated
Apr 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Authorized official

Name
Dr. Susan Virginia Mullen, D.C.NPI 1053404079
Title
Owner
Phone
(510) 356-4048

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 25356 CA Primary

Addresses

Primary practice location

2620 Telegraph Ave
Berkeley, CA 94704-3321

Mailing address

2620 Telegraph Ave
Berkeley, CA 94704-3321
Phone (510) 653-6855

Other identifiers 1

IdentifierTypeStateIssuer
1053404079OtherCANPI

Other names 1

  • The Good Life Chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

2620 Telegraph Ave
Berkeley, CA 94704
Phone (415) 663-6893

Practitioners & affiliated clinicians

Practitioners 2

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": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1932383569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043321",
            "telephone_number": "510-653-6855",
            "fax_number": "510-356-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043321",
            "telephone_number": "510-356-4048",
            "fax_number": "510-356-4137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULLEN CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-18",
        "last_updated": "2013-04-04",
        "status": "A",
        "authorized_official_last_name": "MULLEN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "VIRGINIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-356-4048",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "25356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1053404079",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Good Life Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.