Brand Surgical Institute

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BRAND SURGICAL INSTITUTE

Practice address

716 W Broadway
Glendale, CA 91204-1010

Phone

(818) 243-9999

Fax

(818) 243-9012

NPI assigned

Jan 29, 2021

Organization subpart

No

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

Authorized official

Name

Angel Samvalian

Title

Ceo

Phone

(818) 402-7759

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Ambulatory surgical center certification: CCN 05C0002295

Legal name

BRAND SURGICAL INSTITUTE

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Nov 22, 2021

Last certification

Nov 22, 2021

Ownership / control type

Proprietary

Facility address

716 West Broadway
Glendale, CA 91204

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1083205306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 N BRAND BLVD STE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022577",
            "telephone_number": "818-243-9999",
            "fax_number": "818-243-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 W BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041010",
            "telephone_number": "818-243-9999",
            "fax_number": "818-243-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAND SURGICAL INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "SAMVALIAN",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-402-7759"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brand Medical Center
• Brand Optometry a Prof Corp
• Brand Psychiatric Medical Group
• Brand Royal Homecare
• Brand Surgery Center, LLC
• Brand Surgical Institute Inc
• Karen Renee Brandt, FNP-C
• Priscilla Vanessa Bransby, FNP
• Ghisela Elvira Bravo-Cushing, D.D.S.
• Brenda S Bravo

• Ambulatory Surgical Clinic/Center in Glendale, CA
• Providers in Glendale, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.