NPIMap

Organization Active NPI

Stark Chiropractic, Inc.

Doing business as Tustin Family Chiropractic

  • Chiropractor
  • Tustin, CA
National Provider Identifier
1306040001
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC24623 Issued in CA
Legal business name
STARK CHIROPRACTIC, INC.
Doing business as
Tustin Family Chiropractic
Practice address
13771 Newport Ave
Suite 8
Tustin, CA 92780-4693
Phone
(714) 368-7600
Fax
(714) 368-7630
NPI assigned
Jun 14, 2007
Last updated
Feb 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2011

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

Authorized official

Name
Clinton Russell Stark, D.C.NPI 1124184593
Title
President
Phone
(714) 368-7600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC24623 CA Primary

Addresses

Primary practice location

13771 Newport Ave
Suite 8
Tustin, CA 92780-4693

Mailing address

13771 Newport Ave
Suite 8
Tustin, CA 92780-4693
Phone (714) 368-7600

Other names 1

  • Tustin Family Chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

13771 Newport Ave
Ste 8
Tustin, CA 92780
Phone (714) 368-7600

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1306040001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13771 NEWPORT AVE",
            "address_2": "SUITE 8",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804693",
            "telephone_number": "714-368-7600",
            "fax_number": "714-368-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13771 NEWPORT AVE",
            "address_2": "SUITE 8",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804693",
            "telephone_number": "714-368-7600",
            "fax_number": "714-368-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARK CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2011-02-16",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-368-7600",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC24623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tustin Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tustin, CA

Sources for this page

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