Debruin Medical Center a.P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A5579 Issued in CA

Legal business name

DEBRUIN MEDICAL CENTER A.P.C.

Practice address

9352 Madison Ave
Ste. One
Orangevale, CA 95662-4968

Phone

(916) 989-2929

Fax

(916) 989-0322

NPI assigned

Feb 26, 2008

Last updated

Feb 26, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark Ike Debruin, D.O.NPI 1154327518

Title

Owner

Phone

(916) 989-2929

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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.

• Mark Ike Debruin, D.O.

  • Family Medicine Physician
  • Orangevale, CA
  • NPI 1154327518
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1104095975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9352 MADISON AVE",
            "address_2": "STE. ONE",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956624968",
            "telephone_number": "916-989-2929",
            "fax_number": "916-989-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9352 MADISON AVE",
            "address_2": "STE. ONE",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956624968",
            "telephone_number": "916-989-2929",
            "fax_number": "916-989-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBRUIN MEDICAL CENTER A.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "DEBRUIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "IKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-989-2929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emese Elisabeth Dabic
• Dani's Helping Hands, Inc. (Dani's Helping Hands 2)
• Darrell Broaddus Psychological Services PC
• Kristine Davenport, PT
• Gasem Dawara
• Debruin Research, Inc
• Mark Ike Debruin, D.O.
• Danielle Rayleen Deltoro
• Neha Devi
• Eugene Dey, CADC III

• Family Medicine Physician in Orangevale, CA
• Providers in Orangevale, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; 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.