Individual provider Active NPI

Randy Bruce Wasoff, D.C.

  • Chiropractor
  • Burbank, CA
National Provider Identifier
1215942628
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC14271 Issued in CA
Practice address
4444 W Riverside Dr
Suite 101
Burbank, CA 91505-4073
Phone
(818) 845-8500
Fax
(818) 845-8543
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC14271 CA Primary

Addresses

Primary practice location

4444 W Riverside Dr
Suite 101
Burbank, CA 91505-4073

Mailing address

4444 W Riverside Dr
Suite 101
Burbank, CA 91505-4073
Phone (818) 845-8500

Other identifiers 1

IdentifierTypeStateIssuer
DC14271OtherCASTATE LICENSE NUMBER

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

LicenseStateTypeSpecialty
14271CAMDProfessional Counselor
DC14271CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1215942628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 W RIVERSIDE DR",
            "address_2": "SUITE 101",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054073",
            "telephone_number": "818-845-8500",
            "fax_number": "818-845-8543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 W RIVERSIDE DR",
            "address_2": "SUITE 101",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054073",
            "telephone_number": "818-845-8500",
            "fax_number": "818-845-8543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASOFF",
        "first_name": "RANDY",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC14271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "DC14271",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.

Verify at the official NPI Registry.