Randall Craig Stark, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC20409 Issued in CA

Practice address

4132 Katella Ave Ste 102
Los Alamitos, CA 90720-3491

Phone

(562) 493-4473

Fax

(562) 493-4824

NPI assigned

May 3, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stark Family Chiropractic Inc.

  • Chiropractor
  • Fountain Valley, CA
  • NPI 1497138424
  Medicare reassignment
• Shahba Body Revive Chiropractic Corporation

  dba Alamitos back pain center

  • Chiropractor
  • Los Alamitos, CA
  • NPI 1538889373
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568674737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4132 KATELLA AVE STE 102",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203491",
            "telephone_number": "562-493-4473",
            "fax_number": "562-493-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4132 KATELLA AVE STE 102",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203491",
            "telephone_number": "562-493-4473",
            "fax_number": "562-493-4824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "RANDALL",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC20409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Southwick, LMFT
• Dylan Spetzman, PTA
• St. Joseph Hospice and Palliative Care, Inc.
• Corinne Stamm
• Stanley Chou Medical Corporation
• Monica Stel
• Stellar Prosthetics & Orthotics
• Stephanie a. Dodson DDS Ms
• Stephen Michael Eskaros, M.D., Inc.
• Mara L Stevens, PA-C

• Chiropractor in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.