Bristol McFadden Medical Group, Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

BRISTOL MCFADDEN MEDICAL GROUP, INC.

Practice address

1226 E McFadden Ave
Santa Ana, CA 92705-4106

Phone

(714) 245-0288

Fax

(714) 245-0488

NPI assigned

Nov 1, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Kasin Ekmaha Chai, M.D.

Title

President of Corporation

Phone

(714) 966-0646

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

Bristol McFadden Medical Group Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bristol McFadden Medical Group,Inc.

  • Pediatrics Physician
  • Santa Ana, CA
  • NPI 1003902610
  NPD tax ID

Locations

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1376843771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 E MCFADDEN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054106",
            "telephone_number": "714-245-0288",
            "fax_number": "714-245-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 E MCFADDEN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054106",
            "telephone_number": "714-245-0288",
            "fax_number": "714-245-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL MCFADDEN MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-01",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "CHAI",
        "authorized_official_first_name": "KASIN",
        "authorized_official_middle_name": "EKMAHA",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "714-966-0646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0009850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annamarie Briones
• Andrea Briseno Tellez
• Adrian A Briseno
• Ana T Briseno, NONE
• Bristol Drug Co., Inc
• Bristol McFadden Medical Group,Inc.
• Bristol Park Medical Group, Inc.
• Bristol Physical Therapy & Sports Medicine Center
• Bristol Plaza Family Medicine, a Professional Medical Corporation
• Alma Brito

• Pediatrics Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.

Verify at the official NPI Registry.