Brian Blaisch, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G64161 Issued in CA

Practice address

2700 International Blvd
Suite 11
Oakland, CA 94601-1520

Phone

(510) 533-1248

Fax

(510) 533-1870

NPI assigned

Jul 26, 2006

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

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Contra Costa County

  • Adult Mental Health Clinic/Center
  • San Pablo, CA
  • NPI 1376620336
  Medicare reassignment NPD
• Contra Costa County

  • Adult Mental Health Clinic/Center
  • Pittsburg, CA
  • NPI 1073691598
  NPD
• Contra Costa County

  • General Acute Care Hospital
  • Martinez, CA
  • NPI 1386719086
  NPD

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1184648909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 INTERNATIONAL BLVD",
            "address_2": "SUITE 11",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946011520",
            "telephone_number": "510-533-1248",
            "fax_number": "510-533-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 INTERNATIONAL BLVD",
            "address_2": "SUITE 11",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946011520",
            "telephone_number": "510-533-1248",
            "fax_number": "510-533-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISCH",
        "first_name": "BRIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G64161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "G64161",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Ann Blai
• Jeffrey Blair
• Patricia Blair, M.A., MFTI
• Gretchen Blais, MFC
• Nyah Grace Blais, L.AC
• Amanda Blake, MD
• Amy Blake, DDS
• Katherine Blake, LVN
• Kimberly Blake
• Aubrey Blalock

• Pediatrics Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.