Active NPI
Brandon Adam Gaines, M.S.O.M, LAC
- Addiction (Substance Use Disorder) Counselor
- Los Angeles, CA
National Provider Identifier
1295759199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 1454 S Crest Dr
Los Angeles, CA 90035-3312 - Phone
- (818) 961-4046
- NPI assigned
- Jul 26, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC 10786 | CA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CA | Primary |
Addresses
Primary practice location
1454 S Crest Dr
Los Angeles, CA 90035-3312
Mailing address
1454 S Crest Dr
Los Angeles, CA 90035-3312
Phone (818) 961-4046
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC 10786 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518652800000",
"number": "1295759199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1454 S CREST DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900353312",
"telephone_number": "818-961-4046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1454 S CREST DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900353312",
"telephone_number": "818-961-4046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAINES",
"first_name": "BRANDON",
"middle_name": "ADAM",
"credential": "M.S.O.M, LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2018-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 10786",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.