Bristol Park Medical Group, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BRISTOL PARK MEDICAL GROUP, INC

Practice address

15 Mareblu
Suite 100
Aliso Viejo, CA 92656-3015

Phone

(949) 448-0656

Fax

(949) 425-2465

NPI assigned

May 26, 2006

Last updated

May 7, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark D Schafer, MDNPI 1417948894

Title

Medical Director

Phone

(714) 665-1600

Specialties & licenses 4

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark D Schafer, MD

  • Internal Medicine Physician
  • Tustin, CA
  • NPI 1417948894
  Authorized official Same address or phone

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241654400000",
    "number": "1437105509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2742 DOW AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807242",
            "telephone_number": "714-665-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MAREBLU",
            "address_2": "SUITE 100",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563015",
            "telephone_number": "949-448-0656",
            "fax_number": "949-425-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL PARK MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2009-05-07",
        "status": "A",
        "authorized_official_last_name": "SCHAFER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "714-665-1600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR006919J",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Surinder P. Brar, P.T.
• Brenda Lee Brazier
• Yvonne Bergeon Brewer, MPT
• Bridge Diagnostics LLC
• Brighter Days ABA, LLC
• Jacqueline Jeanette Brodsky, N.P.
• Darryl Brooks, HIS
• Baylee Brown, MA, CCC-SLP
• Hosea Brown III, M.D.
• Mikayla Morgan Brown

• Family Medicine Physician in Aliso Viejo, CA
• Providers in Aliso Viejo, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; 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.