Jan M. Eckermann, MD Inc.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

JAN M. ECKERMANN, MD INC.

Doing business as

Jan M Eckermann MD INC

Practice address

1617 W Cliff Dr
Ste 203
Newport Beach, CA 92660

Phone

(661) 843-7880

NPI assigned

Jul 24, 2019

Organization subpart

No

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

Authorized official

Name

Ginger Johnson

Title

Admin

Phone

(818) 294-2657

Specialties & licenses 1

Addresses

Other names 1

• Jan M Eckermann MD INC Doing business as

Locations

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567641600000",
    "number": "1154974525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 E COAST HWY STE 519",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252328",
            "telephone_number": "661-843-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 W CLIFF DR",
            "address_2": "STE 203",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "661-843-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAN M. ECKERMANN, MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-09-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GINGER",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "818-294-2657"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jan M Eckermann MD INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jan M Eckermann MD INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Neurological Surgery Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.