Stephen D Bragin, M.D., Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

G30255 Issued in CA

Legal business name

STEPHEN D BRAGIN, M.D., INC

Practice address

1225 Wilshire Blvd
Los Angeles, CA 90017

Phone

(213) 977-2280

Fax

(213) 202-7224

NPI assigned

Feb 27, 2008

Organization subpart

No

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

Authorized official

Name

Stephen D Bragin, M.D.NPI 1811090111

Title

Owner

Phone

(213) 977-2280

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen D Bragin, M.D.

  • Urology Physician
  • Los Angeles, CA
  • NPI 1811090111
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562112000000",
    "number": "1457520116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3201",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912210201",
            "telephone_number": "213-977-2000",
            "fax_number": "213-977-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90017",
            "telephone_number": "213-977-2280",
            "fax_number": "213-202-7224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 S Alvarado St Ste 215",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900572388",
            "country_code": "US",
            "telephone_number": "310-422-5558",
            "fax_number": "310-475-0825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STEPHEN D BRAGIN, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2019-07-03",
        "status": "A",
        "authorized_official_last_name": "BRAGIN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-977-2280",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "G30255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.