Organization Active NPI

Seal Beach Medical, LLC

  • Orthopedic Chiropractor
  • Seal Beach, CA
National Provider Identifier
1932990793
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
Legal business name
SEAL BEACH MEDICAL, LLC
Practice address
1198 Pacific Coast Hwy
Suite D #519
Seal Beach, CA 90740
Phone
(562) 566-2829
Fax
(562) 550-7560
NPI assigned
May 13, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Authorized official

Name
Richard Miller
Title
Colletor
Phone
(562) 566-2829

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Orthopedic ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NX0800X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

1198 Pacific Coast Hwy
Suite D #519
Seal Beach, CA 90740

Mailing address

1077 Pacific Coast Hwy Ste 293
Seal Beach, CA 90740-6214
Phone (562) 566-2829

National Provider Directory

National Provider Directory

Locations

1077 Pacific Coast Hwy
Seal Beach, CA 90740
Phone (323) 792-2540

NPI Registry JSON

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

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1932990793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 PACIFIC COAST HWY STE 293",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907406214",
            "telephone_number": "562-566-2829",
            "fax_number": "562-550-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1198 PACIFIC COAST HWY",
            "address_2": "SUITE D #519",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "90740",
            "telephone_number": "562-566-2829",
            "fax_number": "562-550-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAL BEACH MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "COLLETOR",
        "authorized_official_telephone_number": "562-566-2829"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 May 13, 2025; 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.