Brian Dam, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

54999 Issued in CA

Practice address

2720 N Harbor Blvd Ste 210
Fullerton, CA 92835-2626

Phone

(714) 446-5192

NPI assigned

Oct 18, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• San Bernardino Medical Orthopaedic Group, Inc.

  • Orthopaedic Surgery Physician
  • Redlands, CA
  • NPI 1336187475
  Medicare reassignment NPD
• Healthcare Service Partners, Inc.

  • Surgical Physician Assistant
  • Rancho Santa Margarita, CA
  • NPI 1356889265
  Medicare reassignment
• San Bernardino Medical Orthopaedic Group, Inc.

  • Orthopaedic Surgery Physician
  • Beaumont, CA
  • NPI 1235964537
  NPD
• Physician Assistant Specialists-California Inc

  • Surgical Physician Assistant
  • Rancho Santa Margarita, CA
  • NPI 1245017185
  NPD (past)
• Spine and Pain Institute of Orange County, Inc.

  • Orthopaedic Surgery Physician
  • Irvine, CA
  • NPI 1609145127
  NPD (past)

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640995200000",
    "number": "1104337054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5099",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928635099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 N HARBOR BLVD STE 210",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352626",
            "telephone_number": "714-446-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAM",
        "first_name": "BRIAN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-18",
        "last_updated": "2022-01-01",
        "certification_date": "2022-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryam Dadashi
• Patrick Robert Dahl, MD
• Samantha Lynn Dakin
• Dale M. Rosenblum, DPM Inc
• Heather Joy Dale, LCSW
• Zeba Damani
• Alan Dang
• Anh T Dang
• Khang Nguyenphuc Dang
• Darrisha Daniel

• Physician Assistant in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.