BR Medivan Inc.

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

BR MEDIVAN INC.

Practice address

2689 Presidio Dr
Brentwood, CA 94513-5609

Phone

(925) 848-1715

Fax

(925) 392-8589

NPI assigned

May 19, 2023

Organization subpart

No

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

Authorized official

Name

Mark RuizNPI 1396436267

Title

President

Phone

(925) 698-1207

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BR Medivan Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Ericson Ruiz

  • Driver
  • Brentwood, CA
  • NPI 1396436267
  NPD Authorized official

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1235820150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2689 PRESIDIO DR",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945135609",
            "telephone_number": "925-848-1715",
            "fax_number": "925-392-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2689 PRESIDIO DR",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945135609",
            "telephone_number": "925-848-1715",
            "fax_number": "925-392-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BR MEDIVAN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-698-1207"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396436267",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BR Medivan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Reneta A Botros, DPT
• Maria Bernadette Calvez Bounnong
• Maurice Ray Bow
• Emily Bowes, PPSP
• Brittany Boyer
• Braden Partners LP
• Kelly Bradley, MFT
• Megan Maureen Bradley, MA
• Camhuyen T Brais-Nguyen, M.S.
• Makaela Brame

• Non-emergency Medical Transport (VAN) in Brentwood, CA
• Providers in Brentwood, CA by specialty
• Non-emergency Medical Transport (VAN) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.