Active NPI
Gregory Scott Stayberg, D.C.
- Chiropractor
- Los Angeles, CA
National Provider Identifier
1154735710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 34271
- Practice address
- 1870 Westwood Blvd
Los Angeles, CA 90025-4612 - Phone
- (213) 515-5151
- NPI assigned
- Jun 11, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 34271 | CA | Primary |
Addresses
Primary practice location
1870 Westwood Blvd
Los Angeles, CA 90025-4612
Mailing address
13020 Ardath Ave
Gardena, CA 90249-1525
Phone (310) 650-1104
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34271 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692576000000",
"number": "1154735710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13020 ARDATH AVE",
"city": "GARDENA",
"state": "CA",
"postal_code": "902491525",
"telephone_number": "310-650-1104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1870 WESTWOOD BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900254612",
"telephone_number": "213-515-5151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAYBERG",
"first_name": "GREGORY",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-11",
"last_updated": "2023-08-21",
"certification_date": "2023-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "34271",
"primary": true
}
],
"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 Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.