Bristol Park Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BRISTOL PARK MEDICAL GROUP, INC.

Practice address

1212 W 17TH St
Santa Ana, CA 92706-3418

Phone

(714) 954-0432

Fax

(714) 796-6265

NPI assigned

May 28, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mark D Schafer, MD

Title

Medical Director

Phone

(714) 665-1661

Specialties & licenses 4

Addresses

Other identifiers 1

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1275580995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2742 DOW AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807242",
            "telephone_number": "714-665-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 W 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063418",
            "telephone_number": "714-954-0432",
            "fax_number": "714-796-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL PARK MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "SCHAFER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "714-665-1661",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR006919H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adrian A Briseno
• Ana T Briseno, NONE
• Bristol Drug Co., Inc
• Bristol McFadden Medical Group, Inc.
• Bristol McFadden Medical Group,Inc.
• Bristol Physical Therapy & Sports Medicine Center
• Bristol Plaza Family Medicine, a Professional Medical Corporation
• Alma Brito
• Bianca Brito, LCSW
• Eva Brito

• Family Medicine Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; 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.