NPIMap

Organization Active NPI

HD Physical Medicine, a Professional Medical Corporation

Doing business as Dba: Stine Chiropractic

  • Chiropractor
  • Victorville, CA
National Provider Identifier
1982633863
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
HD PHYSICAL MEDICINE, A PROFESSIONAL MEDICAL CORPORATION
Doing business as
Dba: Stine Chiropractic
Practice address
17330 Bear Valley Rd
Ste 105
Victorville, CA 92395
Phone
(760) 245-8182
Fax
(760) 245-2123
NPI assigned
Jul 2, 2006
Last updated
Apr 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Authorized official

Name
Dr. Gabriel L Stine, D.C.NPI 1114957602
Title
Vice President
Phone
(760) 245-8182

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X NU
Pain Medicine (Anesthesiology) Physician 207LP2900X NU
Vascular Surgery Physician 2086S0129X NU
Athletic Trainer 2255A2300X NU

Addresses

Primary practice location

17330 Bear Valley Rd
Ste 105
Victorville, CA 92395

Mailing address

17330 Bear Valley Rd
Ste 105
Victorville, CA 92395
Phone (760) 245-8182

Other names 1

  • DBA: STINE CHIROPRACTIC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210820003081 CA Part B Supplier - Clinic/Group Practice 3678974243 Receives reassigned benefits from 11 practitioners
Practice locations: Victorville, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1982633863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17330 BEAR VALLEY RD",
            "address_2": "STE 105",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "760-245-8182",
            "fax_number": "760-245-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17330 BEAR VALLEY RD",
            "address_2": "STE 105",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "760-245-8182",
            "fax_number": "760-245-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HD PHYSICAL MEDICINE, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2025-04-10",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "STINE",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "760-245-8182",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA: STINE CHIROPRACTIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.