Active NPI
Brian Keith Holiwell, M.D.
- Pediatrics Physician
- Anaheim, CA
National Provider Identifier
1245674522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G52056
- Practice address
- 411 N Lakeview Ave
Anaheim, CA 92807-3028 - Phone
- (714) 279-4675
- NPI assigned
- Apr 17, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G52056 | CA | Primary |
Addresses
Primary practice location
411 N Lakeview Ave
Anaheim, CA 92807-3028
Mailing address
13052 Sutton St
Cerritos, CA 90703-8729
Phone (562) 404-2736
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G52056 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366156800000",
"number": "1245674522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13052 SUTTON ST",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907038729",
"telephone_number": "562-404-2736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 N LAKEVIEW AVE",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928073028",
"telephone_number": "714-279-4675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLIWELL",
"first_name": "BRIAN",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-04-17",
"last_updated": "2013-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G52056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.