Gary Brazina, M. D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

G37830 Issued in CA

Practice address

13160 Mindanao Way
Ste 300
Marina del Rey, CA 90292-6358

Phone

(310) 821-2222

Fax

(310) 823-5871

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Gary Brazina MD Inc.

  • Non-Pharmacy Dispensing Site
  • Marina del Rey, CA
  • NPI 1922307669
  NPD (past) Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376655142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13160 MINDANAO WAY",
            "address_2": "STE 300",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926358",
            "telephone_number": "310-821-2222",
            "fax_number": "310-823-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13160 MINDANAO WAY",
            "address_2": "STE 300",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926358",
            "telephone_number": "310-821-2222",
            "fax_number": "310-823-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZINA",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G37830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G37830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard George Boudreau, D.D.S.
• Nicole Teresse Bowlin, DPT
• Evan Brahce, D.P.T.
• Zayra Bravo
• Robert S Bray Jr., M.D.
• Seth Adam Brener, M.D.
• Brian K. Estwick, M.D., Inc.
• Connie Elaine Bright, SPEECH LANGUAGE PATH
• Karen Eiko Brodersen, PHARM.D.
• Nicki Broeking, PSY.D

• Specialist in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.