Individual provider Active NPI

Cameron Maclean Bransby Zachary, MD

  • Student in an Organized Health Care Education/Training Program
  • Irvine, CA
National Provider Identifier
1073191631
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
118 Medical Surge
Irvine, CA 92697-2400
Phone
(949) 824-5515
Fax
(949) 824-7454
NPI assigned
Apr 1, 2021
Last updated
Feb 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

118 Medical Surge
Irvine, CA 92697-2400

Mailing address

118 Medical Surge
Irvine, CA 92697-2400
Phone (949) 824-5515

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230828002392 CA Order and Referring Only - DermatologyPractitioner - Dermatology 4981067725

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
Georgetown University School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9900 N Central Expy
Suite 500
Dallas, TX 75231-0928

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1073191631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 MEDICAL SURGE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926972400",
            "telephone_number": "949-824-5515",
            "fax_number": "949-824-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MEDICAL SURGE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926972400",
            "telephone_number": "949-824-5515",
            "fax_number": "949-824-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARY",
        "first_name": "CAMERON",
        "middle_name": "MACLEAN BRANSBY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.