NPIMap

Organization Active NPI

Brian K Gamble, M.D. Inc

  • Family Medicine Physician
  • Van Nuys, CA
National Provider Identifier
1386848612
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
W20244A Issued in CA
Legal business name
BRIAN K GAMBLE, M.D. INC
Practice address
13521 Sherman Way
Unit D
Van Nuys, CA 91405-2894
Phone
(818) 786-5360
Fax
(818) 786-5670
NPI assigned
Jun 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Authorized official

Name
Dr. Brian Keith Gamble, M.D.
Title
C.E.O.
Phone
(818) 786-5360

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X W20244A CA Primary
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A0401X A76121 CA

Addresses

Primary practice location

13521 Sherman Way
Unit D
Van Nuys, CA 91405-2894

Mailing address

13521 Sherman Way
Unit D
Van Nuys, CA 91405-2894
Phone (818) 786-5360

Other identifiers 1

IdentifierTypeStateIssuer
A76121OtherCASTATE LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Brian K Gamble MD Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201046400000",
    "number": "1386848612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13521 SHERMAN WAY",
            "address_2": "UNIT D",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914052894",
            "telephone_number": "818-786-5360",
            "fax_number": "818-786-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13521 SHERMAN WAY",
            "address_2": "UNIT D",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914052894",
            "telephone_number": "818-786-5360",
            "fax_number": "818-786-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN K GAMBLE, M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2008-01-23",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "818-786-5360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "W20244A",
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "CA",
            "license": "A76121",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A76121",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

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