DR. JILL RUESCH-LANE D.C., NPI 1164590121 — LOS ANGELES (CA)

NPI 1164590121

13+ Years Experience Individual

DR. JILL RUESCH-LANE D.C.

11/30/2006
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1164590121
NPI NUMBER

About DR. JILL RUESCH-LANE

Sole proprietor? Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor.

DR. JILL RUESCH-LANE is a provider established in LOS ANGELES, CA. The NPI number of DR. JILL RUESCH-LANE is 1164590121 and was assigned on 11/30/2006. The practitioners primary taxonomy code is: 111N00000X CA .

Mailing address

  • City: LOS ANGELES
  • State: CA
  • Postal code: 90048
  • Phone: 3236533362
  • Fax: 3236532720
  • Address: 6404 WILSHIRE BLVD
  • Address 2: SUITE 701

Primary Practice Address

  • Region : LOS ANGELES, CA
  • NPI : 1164590121
  • Phone : 3236533362
  • Fax : 3236532720
  • Postalcode : 900485501
  • Address : 6404 WILSHIRE BLVD SUITE 701

Provider taxonomy - Chiropractor

  • Taxonomy code: 111N00000X
  • License state: CA

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: 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.

Contacts:

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  • DR. JILL RUESCH-LANE D.C.
  • Address : 6404 WILSHIRE BLVD SUITE 701
  • Region : LOS ANGELES, CA
  • NPI : 1164590121
  • Phone : 3236533362
  • Fax : 3236532720
  • Postalcode : 900485501

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address6404 WILSHIRE BLVD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE 701
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameLOS ANGELES
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCA
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code900485501
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3236533362
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3236532720
The fax number associated with the location address of the provider being identified.
NPI1164590121
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1111N00000X
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.
Provider Enumeration Date11/30/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)DR. JILL RUESCH-LANE
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address6404 WILSHIRE BLVD
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE 701
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameLOS ANGELES
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameCA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code90048
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3236533362
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number3236532720
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1111N00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Chiropractor
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.
Provider License Number State Code 1CA
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorY
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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