Individual provider Active NPI

Vaughn Darst, RD

  • Registered Dietitian
  • Los Angeles, CA
National Provider Identifier
1679110746
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86107794 Issued in CA
Practice address
1231 S Plymouth Blvd Apt 102
Los Angeles, CA 90019-6881
Phone
(562) 290-2431
Fax
(562) 264-1215
NPI assigned
Dec 6, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86107794 CA Primary

Addresses

Primary practice location

1231 S Plymouth Blvd Apt 102
Los Angeles, CA 90019-6881

Mailing address

1231 S Plymouth Blvd Apt 102
Los Angeles, CA 90019-6881
Phone (562) 290-2431

Other practice location 1

21515 Hawthorne Blvd Ste 370
Torrance, CA 90503-6556
Phone (424) 341-5407 ext. 104

Other practice location 2

1231 S Plymouth Blvd Apt 102
Los Angeles, CA 90019-6881
Phone (562) 290-2431

Other identifiers 1

IdentifierTypeStateIssuer
86107794OtherCACOMMISSION ON DIETETIC REGISTRATION

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address vaughn@allgendernutrition.com Direct
Direct Messaging Address vaughn@allgendernutrition.com Direct

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

LicenseStateTypeSpecialty
86107794CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1679110746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 S PLYMOUTH BLVD APT 102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900196881",
            "telephone_number": "562-290-2431",
            "fax_number": "562-264-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 S PLYMOUTH BLVD APT 102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900196881",
            "telephone_number": "562-290-2431",
            "fax_number": "562-264-1215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21515 Hawthorne Blvd Ste 370",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905036556",
            "country_code": "US",
            "telephone_number": "424-341-5407 x104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1231 S Plymouth Blvd Apt 102",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900196881",
            "country_code": "US",
            "telephone_number": "562-290-2431",
            "fax_number": "562-264-1215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DARST",
        "first_name": "VAUGHN",
        "name_prefix": "Mr.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-06",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86107794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "86107794",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vaughn@allgendernutrition.com",
            "affiliation": "N",
            "endpointDescription": "secure business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Secure Email",
            "address_1": "1231 S Plymouth Blvd Apt 102",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900196881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vaughn@allgendernutrition.com",
            "affiliation": "N",
            "endpointDescription": "secure business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Secure Email",
            "address_1": "1231 S Plymouth Blvd Apt 102",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900196881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Dec 6, 2019; 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.