Mark a. Bronstein, M.D., Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

MARK A. BRONSTEIN, M.D., INC

Practice address

11180 Warner Ave Ste 163
Fountain Valley, CA 92708-7515

Phone

(714) 751-1188

Fax

(714) 751-2403

NPI assigned

Dec 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Bronstein, M.D.

Title

President

Phone

(714) 751-1188

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197504000000",
    "number": "1124201033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE STE 163",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087515",
            "telephone_number": "714-751-1188",
            "fax_number": "714-751-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE STE 163",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087515",
            "telephone_number": "714-751-1188",
            "fax_number": "714-751-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. BRONSTEIN, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2007-12-13",
        "status": "A",
        "authorized_official_last_name": "BRONSTEIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-751-1188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0162028",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "A92508",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; 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.