Organization Active NPI

Joey Brett MD a Professional Medical Corporation

  • Family Medicine Physician
  • Sherman Oaks, CA
National Provider Identifier
1003927872
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A55102 Issued in CA
Legal business name
JOEY BRETT MD A PROFESSIONAL MEDICAL CORPORATION
Practice address
13320 Riverside Dr
Suite 104
Sherman Oaks, CA 91423-2502
Phone
(818) 789-0034
Fax
(818) 789-0042
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Joey Brett, MD
Title
Ceo
Phone
(818) 789-0034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A55102 CA Primary

Addresses

Primary practice location

13320 Riverside Dr
Suite 104
Sherman Oaks, CA 91423-2502

Mailing address

12400 Ventura Blvd
# 738
Studio City, CA 91604-2406
Phone (818) 789-0034

Other identifiers 2

IdentifierTypeStateIssuer
1003927872OtherCANPI
00A551020OtherCAMEDI-CAL NUMBER

National Provider Directory

National Provider Directory

Locations

13320 Riverside Dr
Ste 104
Sherman Oaks, CA 91423
Phone (818) 574-6189

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1003927872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12400 VENTURA BLVD",
            "address_2": "# 738",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042406",
            "telephone_number": "818-789-0034",
            "fax_number": "818-789-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13320 RIVERSIDE DR",
            "address_2": "SUITE 104",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914232502",
            "telephone_number": "818-789-0034",
            "fax_number": "818-789-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEY BRETT MD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "BRETT",
        "authorized_official_first_name": "JOEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-789-0034",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A55102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1003927872",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL NUMBER",
            "identifier": "00A551020",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.

Verify at the official NPI Registry.