Stanley A Kaller, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A3703 Issued in CA

Practice address

15111 Whittier Blvd
Ste 102
Whittier, CA 90603-2136

Phone

(562) 945-6440

Fax

(562) 945-9121

NPI assigned

Jul 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262131200000",
    "number": "1013917145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15111 WHITTIER BLVD",
            "address_2": "STE 102",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906032136",
            "telephone_number": "562-945-6440",
            "fax_number": "562-945-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15111 WHITTIER BLVD",
            "address_2": "STE 102",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906032136",
            "telephone_number": "562-945-6440",
            "fax_number": "562-945-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLER",
        "first_name": "STANLEY",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2009-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A3703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "B005",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD PIN",
            "identifier": "010054114",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX37030",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "20A3703",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "020A37030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• K. Kang, J. Lee & P. Kang DDS Inc
• K.S.Prasad DDS Inc
• Kaiser Foundation Health Plan Inc
• Shiv Kalaria
• Cortney Kaller, RDN. CNSC
• Moses Mbugua Kamau
• Rachel Kamen, CCC-SLP
• June T. Kaneoka, D.D.S.
• Alex Min Koo Kang
• Gloria Kang

• Family Medicine Physician in Whittier, CA
• Providers in Whittier, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.