Active NPI
Susan Stangl, MD
- Family Medicine Physician
- Santa Monica, CA
National Provider Identifier
1396769477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G37063
- Practice address
- 1920 Colorado Ave
Santa Monica, CA 90404-3414 - Phone
- (310) 317-4700
- NPI assigned
- Jul 26, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G37063 | CA | Primary |
Addresses
Primary practice location
1920 Colorado Ave
Santa Monica, CA 90404-3414
Mailing address
5767 W Century Blvd
Suite 200
Los Angeles, CA 90045-5632
Phone (310) 301-8708
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G370630 | Medicaid | CA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G37063 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218499200000",
"number": "1396769477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD",
"address_2": "SUITE 200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455632",
"telephone_number": "310-301-8708",
"fax_number": "310-301-8751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1920 COLORADO AVE",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904043414",
"telephone_number": "310-317-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANGL",
"first_name": "SUSAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2008-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G37063",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G370630",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.