Individual provider Active NPI

Brian Cravanas II, MD

  • Neurology Physician
  • Loma Linda, CA
National Provider Identifier
1427477629
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A155956 Issued in CA
Practice address
11370 Anderson St Ste B-100
Loma Linda, CA 92354
Phone
(909) 558-2880
NPI assigned
Apr 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A155956 CA Primary

Addresses

Primary practice location

11370 Anderson St Ste B-100
Loma Linda, CA 92354

Mailing address

11370 Anderson St Ste B-100
Loma Linda, CA 92354-3450
Phone (909) 558-2880

Other practice location 1

1411 E 31st St
Oakland, CA 94602-1018
Phone (510) 437-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180903000124 CA Practitioner - Neurology 4587954235 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A155956CAMDNeurology Physician
008049GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 16, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 16, 2018 Accepting new patients

Locations

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11370 Anderson St
Ste B100
Loma Linda, CA 92354
Phone (909) 558-2848

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

28078 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

Interoperability endpoints

  • Direct secure messaging: brian.cravanasii@hca2.eclinicaldirectplus.com
  • Direct secure messaging: bcravanas178254@direct.llu.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1427477629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST STE B-100",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST STE B-100",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354",
            "telephone_number": "909-558-2880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 E 31st St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946021018",
            "country_code": "US",
            "telephone_number": "510-437-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAVANAS",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A155956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.