NPIMap

Organization Active NPI

Brentwood Urgent Care

  • Urgent Care Clinic/Center
  • Santa Monica, CA
National Provider Identifier
1053850800
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
BRENTWOOD URGENT CARE
Practice address
1156 26TH St
Santa Monica, CA 90403-4621
Phone
(310) 829-4505
NPI assigned
Feb 13, 2017
Last updated
Feb 13, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
ANAHEIM URGENT CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Authorized official

Name
Pejman Bolourian, M.D.
Title
Medical Director
Phone
(310) 704-0615

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1156 26TH St
Santa Monica, CA 90403-4621

Mailing address

1156 26TH St
Santa Monica, CA 90403-4621
Phone (310) 829-4505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080606000728 CA Part B Supplier - Clinic/Group Practice 8325118029 Receives reassigned benefits from 172 practitioners
35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Los Angeles, CA; Moorpark, CA; North Hollywood, CA; Pasadena, CA; Rancho Palos Verdes, CA; Santa Monica, CA; Thousand Oaks, CA; Torrance, CA…

Other NPIs on the same Medicare enrollment 35

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 35

National Provider Directory

National Provider Directory
Part of
Brentwood Urgent Care

Locations

1156 26th St
Santa Monica, CA 90403
Phone (310) 829-4505

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1053850800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 26TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034621",
            "telephone_number": "310-829-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 26TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034621",
            "telephone_number": "310-829-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENTWOOD URGENT CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANAHEIM URGENT CARE",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "BOLOURIAN",
        "authorized_official_first_name": "PEJMAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-704-0615",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.