Brian Antony Boben, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

180813 Issued in CA

Practice address

13160 Mindanao Way Ste 301
Marina del Rey, CA 90292-6358

Phone

(310) 301-0230

Fax

(310) 301-0233

NPI assigned

May 1, 2019

Sex

Male

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Regents of the University of CaliforniaGroup PAC ID 1355248584, 1,426 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Los Robles Healthcare Home health agency, Thousand Oaks, CA, CCN 058059
• Western States Homehealth Care Agency, Inc Home health agency, Los Angeles, CA, CCN 058097
• Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112
• Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bboben1132514@direct.uclahealth.org

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

• The Regents of the University of California

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1235107566

  Family Medicine

  Medicare reassignment Care Compare group NPD
• The Regents of the University of California

  • Ambulatory Surgical Clinic/Center
  • Valencia, CA
  • NPI 1689200305
  NPD
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Los Robles Homecare Services Inc

  • Home Health Agency
  • Thousand Oaks, CA
  • NPI 1982602496
  Care Compare affiliation
• Regents of the Univ of California

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1427055839
  Care Compare affiliation
• Regents Univ of Calif Los Angeles

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1902803315
  Care Compare affiliation
• Western States Homehealth Care Agency Inc

  • Home Health Agency
  • Los Angeles, CA
  • NPI 1962474387
  Care Compare affiliation

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1003471434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13160 MINDANAO WAY STE 301",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926358",
            "telephone_number": "310-301-0230",
            "fax_number": "310-301-0233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Alhambra Ave",
            "address_purpose": "LOCATION",
            "city": "Martinez",
            "state": "CA",
            "postal_code": "945533156",
            "country_code": "US",
            "telephone_number": "877-905-4545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-873-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOBEN",
        "first_name": "BRIAN",
        "middle_name": "ANTONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-01",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "180813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Mark Block, D.P.M.
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• Gideon Blumstein, MD, MS
• Jordan Lynn Bobbitt, LCSW
• Shannon Bonness, M.D.
• Elin C Borjas Sr.
• Alborz Borjian, DO
• Barry J Borm, MD
• Lali Borovich

• Family Medicine Physician in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.