COLE G. ELLIS (NPI# 1578694212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578694212 |
| Entity Type | Individual |
| Full Name | COLE G. ELLIS |
| Credential | DC |
| Practice Address |
4490 Fanuel St #d San Diego CA 92109-4292 |
| Mailing Address |
4490 Fanuel St #d San Diego CA 92109-8737 |
| Practice Telephone | 8582749116 |
| Practice Fax Number | 8582749161 |
| Mailing Telephone | 8582749116 |
| Mailing Fax Number | 8582749161 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2012-04-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | DC29817 | CA | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LICENSE | DC18323A | 01 |
| Street Address |
4490 FANUEL ST #D |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92109-4292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710979877 | Michael Bezouska | Preventive Medicine | 4490 Fanuel St, San Diego, CA 92109-8737 | 2005-08-16 |
| 1790342160 | Marque Medical Clinic, Inc. | Clinic/Center | 4490 Fanuel St, San Diego, CA 92109-8737 | 2019-05-21 |
| 1477761807 | Patricia Ann Quinn | Nurse Practitioner | 4490 Fanuel St, San Diego, CA 92109-4292 | 2007-05-18 |
| 1275689994 | Nathaniel G. Rose, M.d., A.p.c. | Family Medicine | 4490 Fanuel St, San Diego, CA 92109-4292 | 2007-01-26 |
| 1114940285 | Leonard Neil Schulkind | Emergency Medicine | 4490 Fanuel St, San Diego, CA 92109-4292 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538620786 | San Diego Forensic Psychology Corporation | Psychologist | 4640 Cass Street, # 90422, San Diego, CA 92109 | 2019-03-29 |
| 1982113874 | Holly Mansur | Registered Nurse | 3663 Jewell Street, San Diego, CA 92109 | 2017-09-24 |
| 1669906178 | Kelley Ann Riley | Prevention Professional | 4328 Gresham St, San Diego, CA 92109 | 2017-04-12 |
| 1689113524 | Tyler Marquis | Pharmacist | 2636 Grand Avenue Apartment 326, San Diego, CA 92109 | 2017-02-13 |
| 1912372574 | Lonnie Butler | Doula | 841 Turquoise Street, F-405, San Diego, CA 92109 | 2015-12-08 |
| 1275924995 | Pratima S. Gowdar, Dds, Inc | Dentist | 4655 Cass St. Ste 104, San Diego, CA 92109 | 2015-02-17 |
| 1417388562 | Pacific Rim Pathology Medical Corporation | Clinical Medical Laboratory | 3030 Bunker Hill Street, Suite 201, San Diego, CA 92109 | 2013-11-27 |
| 1023379997 | Eric Berquist | Student in an Organized Health Care Education/Training Program | 2009 Reed Ave, San Diego, CA 92109 | 2012-06-06 |
| 1982996724 | Miramar Health Physicians Group | Acupuncturist | 1321 Garnet Avenue, San Diego, CA 92109 | 2011-05-12 |
| 1902109325 | Anna N Amagou | Behavioral Analyst | 2221 Felspar Street Apt #c, San Diego, CA 92109 | 2010-12-07 |
| Find all providers in zip 92109 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234286 | Hifai Chiropractic Inc | Chiropractor | 7805 Highland Village Pl Ste 104, San Diego, CA 92129-5181 | 2020-10-28 |
| 1871192922 | Jason Trainer | Chiropractor | 4580 Southampton St, San Diego, CA 92117-4032 | 2020-10-20 |
| 1013548601 | Lianna Hunt | Chiropractor | 4616 Pendleton St, San Diego, CA 92109-3719 | 2020-01-31 |
| 1790328557 | Fillat Chiropractic Inc. | Chiropractor | 10444 Clairemont Mesa Blvd, San Diego, CA 92124-1320 | 2019-10-24 |
| 1710533591 | Shane Kelly, D.c., LLC | Chiropractor | 10803 Vista Sorrento Pkwy Ste 100, San Diego, CA 92121-2792 | 2019-08-16 |
| 1952967812 | Martha Kebede Mekonen | Chiropractor | 2667 Camino Del Rio South, Suite #313, San Diego, CA 92108 | 2019-05-16 |
| 1457817835 | Sean Patrick Golden | Chiropractor | 11199 Sorrento Valley Rd Ste 201, San Diego, CA 92121-1334 | 2019-02-11 |
| 1134683766 | Christopher Jepsen | Chiropractor | 9040 Friars Rd # 401, San Diego, CA 92108-5859 | 2019-01-28 |
| 1346725769 | Ruben Alexander Montane | Chiropractor | 3069 Lincoln Ave, San Diego, CA 92104-3030 | 2018-10-02 |
| 1033691241 | Jeffrey Ray Greenlee Jr. | Chiropractor | 2245 Fenton Pkwy Ste 109, San Diego, CA 92108-4737 | 2018-09-04 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.