NPIMap

Organization Active NPI

Wagner Chiropractic

  • Chiropractor
  • Pacific Palisades, CA
National Provider Identifier
1932405644
Registry record updated Jan 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11827 Issued in CA
Legal business name
WAGNER CHIROPRACTIC
Practice address
17383 W Sunset Blvd Ste A230
Pacific Palisades, CA 90272-4181
Phone
(310) 230-2145
Fax
(310) 230-2152
NPI assigned
Jan 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2011

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

Authorized official

Name
Dr. Edward WagnerNPI 1770310690
Title
President
Phone
(310) 230-2145

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 11827 CA Primary

Addresses

Primary practice location

17383 W Sunset Blvd Ste A230
Pacific Palisades, CA 90272-4181

Mailing address

17383 W Sunset Blvd Ste A230
Pacific Palisades, CA 90272-4181
Phone (310) 230-2145

National Provider Directory

National Provider Directory

Locations

17383 W Sunset Blvd
Ste A230
Pacific Palisades, CA 90272
Phone (310) 230-2145

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1932405644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17383 W SUNSET BLVD STE A230",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902724181",
            "telephone_number": "310-230-2145",
            "fax_number": "310-230-2152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17383 W SUNSET BLVD STE A230",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902724181",
            "telephone_number": "310-230-2145",
            "fax_number": "310-230-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAGNER CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-230-2145",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "11827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Palisades, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.