Active NPI
Angela Faissal, DC
- Sports Physician Chiropractor
- Los Angeles, CA
National Provider Identifier
1376250837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- DC36478
- Practice address
- 11611 San Vincente Blvd.
Los Angeles, CA 90049 - Phone
- (925) 430-6630
- NPI assigned
- Nov 3, 2022
- Last updated
- Nov 3, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | DC36478 | CA | Primary |
Addresses
Primary practice location
11611 San Vincente Blvd.
Los Angeles, CA 90049
Mailing address
879 Michigan Blvd Unit a
Pasadena, CA 91107-5703
Phone (818) 572-5453
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC36478 | CA | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667433600000",
"number": "1376250837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "879 MICHIGAN BLVD UNIT A",
"city": "PASADENA",
"state": "CA",
"postal_code": "911075703",
"telephone_number": "818-572-5453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11611 SAN VINCENTE BLVD.",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90049",
"telephone_number": "925-430-6630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAISSAL",
"first_name": "ANGELA",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-03",
"last_updated": "2022-11-03",
"certification_date": "2022-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "CA",
"license": "DC36478",
"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 Nov 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.