Zakari Larbi Bissani, DC
Individual provider Active NPI Chiropractor · Grand Terrace, CA
NPI 1982254512 · NPPES record last updated Aug 16, 2020
Key facts
- NPI
- 1982254512
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 34858 (CA)
- Practice address
- 12139 Mount Vernon Ave Ste 100
Grand Terrace, CA 92313-5519 - Phone
- (720) 989-0890
- NPI assigned
- Sep 16, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
12139 Mount Vernon Ave
Suite 100
Grand Terrace, CA 92313-5519
Phone (909) 783-4950
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200921001847 | CA | Practitioner - Chiropractic | 7719305994 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHR.008059 | CO | MD | Chiropractor |
Practice roles (2 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bissani Chiropractic and Integrated Health PC | Single Specialty | Current |
Accepting new patients |
| Keough Chiropractic, Inc | Chiropractor | Current |
Accepting new patients |
Locations
12139 Mount Vernon Ave
Ste 100
Grand Terrace, CA 92313
Phone (909) 783-4950
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHR.008059 | CO | |
| Chiropractor |
111N00000X | 34858 | CA | Yes |
Addresses
Primary practice location
12139 Mount Vernon Ave Ste 100
Grand Terrace, CA 92313-5519
Mailing address
12139 Mount Vernon Ave Ste 100
Grand Terrace, CA 92313-5519
Phone (720) 989-0890
Other practice location 1
950 17th St Ste 200
Denver, CO 80202-2803
Phone (303) 292-9992
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8746840562 | Other | NATIONAL REGISTRY OF CERTIFIED MEDICAL EXAMINERS |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Home | Direct |
Other providers in Grand Terrace, CA
- Bella Garden LLC
- Aniyah Nichele Benjamin
- Jade Rivera Berheim
- Christopher A Berrun
- Bissani Chiropractic and Integrated Health PC
- Kelsy Bonnet
- Breaking Cycles Counseling
- William Martin Breer
- Broadscope LLC
- Traci Brown-Bailey
All providers in Grand Terrace, CA · Chiropractor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.