Organization Active NPI

Yamamoto Chiropractic, Inc.

Doing business as Borrego Chiropractic

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1952423360
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC29270 Issued in CA
Legal business name
YAMAMOTO CHIROPRACTIC, INC.
Doing business as
Borrego Chiropractic
Practice address
5995 Mission Gorge Rd
Suite B
San Diego, CA 92120-4028
Phone
(619) 584-8490
Fax
(619) 584-8101
NPI assigned
Apr 4, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Carl Alan Yamamoto, DCNPI 1073506093
Title
President
Phone
(619) 584-8490

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
Chiropractor 111N00000X DC29270 CA Primary

Addresses

Primary practice location

5995 Mission Gorge Rd
Suite B
San Diego, CA 92120-4028

Mailing address

5995 Mission Gorge Rd
Suite B
San Diego, CA 92120-4028
Phone (619) 584-8490

Other identifiers 2

IdentifierTypeStateIssuer
DC29270OtherCACHIROPRACTIC LIC NUMBER
$$$$$$$$$OtherCASOCIAL SECURITY NUMBER

Other names 1

  • Borrego Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100205000224 CA Part B Supplier - Clinic/Group Practice 7810030384 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

2615 Camino del Rio S
Ste 100
San Diego, CA 92108
Phone (619) 584-8490

Practitioners & affiliated clinicians

Practitioners 3

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": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952423360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5995 MISSION GORGE RD",
            "address_2": "SUITE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204028",
            "telephone_number": "619-584-8490",
            "fax_number": "619-584-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5995 MISSION GORGE RD",
            "address_2": "SUITE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204028",
            "telephone_number": "619-584-8490",
            "fax_number": "619-584-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAMAMOTO CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YAMAMOTO",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-584-8490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC29270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC  LIC NUMBER",
            "identifier": "DC29270",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL SECURITY NUMBER",
            "identifier": "$$$$$$$$$",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Borrego Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.