Active NPI
Joel Crandall, MST, CSCS
- Mechanotherapist
- Los Angeles, CA
National Provider Identifier
1700085446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- Practice address
- 2436 Federal Ave
# 1
Los Angeles, CA 90064-2960 - Phone
- (310) 395-3668
- Fax
- (310) 395-3668
- NPI assigned
- Jul 13, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | Primary |
Addresses
Primary practice location
2436 Federal Ave
# 1
Los Angeles, CA 90064-2960
Mailing address
6353 Vicland Place
North Hollywood, CA 91606
Phone (310) 395-3668
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330300800000",
"number": "1700085446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6353 VICLAND PLACE",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "91606",
"telephone_number": "310-395-3668",
"fax_number": "310-395-3668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2436 FEDERAL AVE",
"address_2": "# 1",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900642960",
"telephone_number": "310-395-3668",
"fax_number": "310-395-3668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANDALL",
"first_name": "JOEL",
"name_prefix": "Mr.",
"credential": "MST, CSCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-13",
"last_updated": "2012-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": null,
"license": null,
"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 Feb 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.