NPIMap

Organization Active NPI

Brain Reconnectiom

  • Specialist
  • Irvine, CA
National Provider Identifier
1093104275
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
BRAIN RECONNECTIOM
Practice address
1929 Main St Ste 103
Irvine, CA 92614-6524
Phone
(949) 307-6914
NPI assigned
Jan 12, 2015
Last updated
Jan 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Authorized official

Name
Hela Kammoun, MNRI CORE SPECIALISTNPI 1982006144
Title
General Officer
Phone
(949) 307-6914

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

1929 Main St Ste 103
Irvine, CA 92614-6524

Mailing address

14271 Jeffrey Rd
Irvine, CA 92620-3405
Phone (909) 307-6914

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1421020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421020800000",
    "number": "1093104275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14271 JEFFREY RD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926203405",
            "telephone_number": "909-307-6914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1929 MAIN ST STE 103",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146524",
            "telephone_number": "949-307-6914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN RECONNECTIOM",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A",
        "authorized_official_last_name": "KAMMOUN",
        "authorized_official_first_name": "HELA",
        "authorized_official_title_or_position": "GENERAL OFFICER",
        "authorized_official_telephone_number": "949-307-6914",
        "authorized_official_credential": "MNRI CORE SPECIALIST"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.