Active NPI
John P Brimlow, PAC
- Physician Assistant
- Eureka, CA
National Provider Identifier
1124000922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- OPA10060
- Practice address
- 2505 Lucas St
Eureka, CA 95501-3340 - Phone
- (707) 445-3063
- Fax
- (707) 442-6602
- NPI assigned
- Nov 17, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | OPA10060 | CA | Primary |
Addresses
Primary practice location
2505 Lucas St
Eureka, CA 95501-3340
Mailing address
2505 Lucas St
Eureka, CA 95501-3340
Phone (707) 445-3063
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ28485Z | Other | CA | BLUE SHIELD |
| GR0067130 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPA10060 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1124000922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2505 LUCAS ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955013340",
"telephone_number": "707-445-3063",
"fax_number": "707-442-6602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2505 LUCAS ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955013340",
"telephone_number": "707-445-3063",
"fax_number": "707-442-6602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIMLOW",
"first_name": "JOHN",
"middle_name": "P",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "OPA10060",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ28485Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0067130",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.