CHARLES FAGENHOLZ (NPI# 1841646809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841646809 |
| Entity Type | Individual |
| Full Name | CHARLES FAGENHOLZ |
| Credential | DC |
| Practice Address |
3151 Airway Ave U-3 Costa Mesa CA 92626-4607 |
| Mailing Address |
21264 Beach Blvd #203 Huntington Beach CA 92648-5482 |
| Practice Telephone | 7147548008 |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2016-05-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NI0013X |
Chiropractor Specialization: Independent Medical Examiner |
33312 | CA | Chiropractic Providers |
| Street Address |
3151 AIRWAY AVE U-3 |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-4607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609836469 | Eric A Prouty | Dentist | 3151 Airway Ave, Suite M2, Costa Mesa, CA 92626-4607 | 2006-03-24 |
| 1609342567 | Chris Maa | Acupuncturist | 3151 Airway Ave, Costa Mesa, CA 92626-4607 | 2018-10-18 |
| 1518319946 | Alisa Gardner | Social Worker | 3151 Airway Ave, T2, Costa Mesa, CA 92626-4607 | 2016-07-09 |
| 1821449141 | Nicole Krakora | Naturopath | 3151 Airway Ave, Suite U-3, Costa Mesa, CA 92626-4607 | 2016-06-28 |
| 1275997058 | Scbh Laboratory, LLC | Clinical Medical Laboratory | 3151 Airway Ave, Suite N-1, Costa Mesa, CA 92626-4607 | 2016-04-07 |
| 1215392816 | Hpr Laboratories | Clinical Medical Laboratory | 3151 Airway Ave, Unit G1, Costa Mesa, CA 92626-4607 | 2015-12-23 |
| 1134592249 | Robin Giesen | Marriage & Family Therapist | 3151 Airway Ave, Ste. T-3, Costa Mesa, CA 92626-4607 | 2015-11-11 |
| 1194194860 | Samuel T. Enterprise | Counselor | 3151 Airway Ave, Suite D2, Costa Mesa, CA 92626-4607 | 2015-09-23 |
| 1740664614 | Clint Johnson | Counselor | 3151 Airway Ave, D-1, Costa Mesa, CA 92626-4607 | 2015-07-10 |
| 1699158162 | Richard Plaskett | Counselor | 3151 Airway Ave, D-1, Costa Mesa, CA 92626 | 2015-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536982 | Sergio Gutierrez | Behavior Technician | 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 | 2020-10-22 |
| 1780201848 | Kelly Chauvet | Behavior Technician | 1503 Nutmeg Place Suite 110, Costa Mesa, CA 92626 | 2020-07-06 |
| 1316564610 | Timo Rosa | Behavior Technician | 1503 Nutmeg Place, Suite 110, Costa Mesa, CA 92626 | 2020-07-02 |
| 1255966115 | Dalia A Sehweil | Behavior Technician | 1111 Baker, Costa Mesa, CA 92626 | 2020-03-11 |
| 1265071096 | Austin Stotelmyre | Behavior Technician | 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 | 2019-12-26 |
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1851933550 | Jennifer Rivera | Behavior Technician | 1111 Baker St. Unit #a, Costa Mesa, CA 92626 | 2019-10-14 |
| 1962053595 | Peter Na | Behavior Technician | Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 | 2019-09-25 |
| 1346897147 | Jennifer Lopez | Behavior Technician | 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 | 2019-08-26 |
| 1679134084 | Danny Garcia Chiropractic, PC | Chiropractor | 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 | 2019-06-26 |
| Find all providers in zip 92626 | ||||
| Taxonomy Code | 111NI0013X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Independent Medical Examiner |
| A special evaluator not involved with the medical care of the individual examinee that impartially evaluates the care being provided by other practitioners to clarify clinical, disability, liability or other case issues. |
| Notes: Source: American Board of Independent Medical Examiners [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932718160 | Matthew Anthony O'brien | Chiropractor | 3753 Ridgeview Ct, Morgan Hill, CA 95037-6820 | 2020-07-23 |
| 1699234559 | Skala Chiropractic Inc | Chiropractor | 4413 Sierra Del Sol, Paradise, CA 95969 | 2019-03-19 |
| 1508345539 | City Line Medical Management | Chiropractor | 15741 Woodruff Ave Ste B, Bellflower, CA 90706-4083 | 2018-08-10 |
| 1033612197 | Ian Fitz-gibbon | Chiropractor | 3668 S Soto St, Vernon, CA 90058-1701 | 2018-03-15 |
| 1982114476 | Jennie Lynfred Logue | Chiropractor | 3868 S Centinela Ave Apt 12, Los Angeles, CA 90066-4459 | 2017-10-10 |
| 1477070969 | Gurwinder Kaur Bath | Chiropractor | 2628 El Camino Ave Ste C1, Sacramento, CA 95821-5936 | 2017-08-24 |
| 1407268493 | Greg Michaels LLC | Chiropractor | 6121 Telegraph Rd, Ste 200, Commerce, CA 90040-2501 | 2014-05-23 |
| 1679990782 | Jagtar S Dhesi Dc A Chiropractic Corp | Chiropractor | 947 Bluebell Dr, Livermore, CA 94551-5319 | 2014-03-26 |
| 1598187635 | Ida Molayem | Chiropractor | 6399 Wilshire Blvd Ste 110, Los Angeles, CA 90048-5704 | 2014-01-08 |
| 1619300902 | Daniel F Hillenbrand | Chiropractor | 1561 Trawler St, Discovery Bay, CA 94505-9346 | 2013-08-09 |
| Find all providers with the same taxonomy | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
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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.