NPIMap

Organization Active NPI

La Sports & Spine, Inc.

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1063799286
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC18136 Issued in CA
Legal business name
LA SPORTS & SPINE, INC.
Practice address
10474 Santa Monica Blvd
Suite 304
Los Angeles, CA 90025-6929
Phone
(310) 470-2909
Fax
(310) 470-3286
NPI assigned
Nov 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Authorized official

Name
Dr. Craig Liebenson, D.C.
Title
Doctor of Chiropractic/ Owner
Phone
(310) 470-2909

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X DC18136 CA Primary
Rehabilitation ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NR0400X DC18136 CA

Addresses

Primary practice location

10474 Santa Monica Blvd
Suite 304
Los Angeles, CA 90025-6929

Mailing address

10474 Santa Monica Blvd
Suite 304
Los Angeles, CA 90025-6929
Phone (310) 470-2909

National Provider Directory

National Provider Directory

Locations

10474 Santa Monica Blvd
Ste 304
Los Angeles, CA 90025
Phone (310) 470-2909

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321401600000",
    "number": "1063799286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10474 SANTA MONICA BLVD",
            "address_2": "SUITE 304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256929",
            "telephone_number": "310-470-2909",
            "fax_number": "310-470-3286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10474 SANTA MONICA BLVD",
            "address_2": "SUITE 304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256929",
            "telephone_number": "310-470-2909",
            "fax_number": "310-470-3286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA SPORTS & SPINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A",
        "authorized_official_last_name": "LIEBENSON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC/ OWNER",
        "authorized_official_telephone_number": "310-470-2909",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC18136",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "DC18136",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.