Individual provider Active NPI

Jonathan David Rand, MD

  • Internal Medicine Physician
  • Marina del Rey, CA
National Provider Identifier
1407871106
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G37418 Issued in CA
Practice address
4644 Lincoln Blvd
#113
Marina del Rey, CA 90292-6313
Phone
(310) 821-9800
Fax
(310) 306-0263
NPI assigned
Jul 13, 2006
Last updated
Oct 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G37418 CA Primary

Addresses

Primary practice location

4644 Lincoln Blvd
#113
Marina del Rey, CA 90292-6313

Mailing address

4644 Lincoln Blvd
#113
Marina del Rey, CA 90292-6313
Phone (310) 821-9800

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G37418CAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: jrand212351@direct.cshs.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1407871106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4644 LINCOLN BLVD",
            "address_2": "#113",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926313",
            "telephone_number": "310-821-9800",
            "fax_number": "310-306-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4644 LINCOLN BLVD",
            "address_2": "#113",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926313",
            "telephone_number": "310-821-9800",
            "fax_number": "310-306-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAND",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G37418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.