Organization Active NPI

Stephen Bresnick, M.D., Inc.

  • Specialist
  • Encino, CA
National Provider Identifier
1447551312
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G074248 Issued in CA
Legal business name
STEPHEN BRESNICK, M.D., INC.
Practice address
16633 Ventura Blvd
Suite 110
Encino, CA 91436-1801
Phone
(818) 981-3333
Fax
(818) 981-0249
NPI assigned
Nov 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Authorized official

Name
Ms. Pam Rosqui
Title
Office Manager
Phone
(818) 981-3333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X G074248 CA Primary

Addresses

Primary practice location

16633 Ventura Blvd
Suite 110
Encino, CA 91436-1801

Mailing address

16633 Ventura Blvd
Suite 110
Encino, CA 91436-1801
Phone (818) 981-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200415002180 CA Part B Supplier - Clinic/Group Practice 7517397557 Receives reassigned benefits from 1 practitioner
Practice locations: Encino, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588636800000",
    "number": "1447551312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16633 VENTURA BLVD",
            "address_2": "SUITE 110",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361801",
            "telephone_number": "818-981-3333",
            "fax_number": "818-981-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16633 VENTURA BLVD",
            "address_2": "SUITE 110",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914361801",
            "telephone_number": "818-981-3333",
            "fax_number": "818-981-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN BRESNICK, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A",
        "authorized_official_last_name": "ROSQUI",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "818-981-3333",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G074248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.