BR Lab and Radiology

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

A95636 Issued in CA

Legal business name

BR LAB AND RADIOLOGY

Practice address

555 Pier Ave
Ste #1
Hermosa Beach, CA 90254-3839

Phone

(424) 488-0500

NPI assigned

Feb 27, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Bao Thai Nguyen, MD

Title

Medical Director

Phone

(424) 488-0500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1424995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424995200000",
    "number": "1467844407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 PIER AVE",
            "address_2": "STE #1",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902543839",
            "telephone_number": "424-488-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 PIER AVE",
            "address_2": "STE #1",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902543839",
            "telephone_number": "424-488-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BR LAB AND RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-27",
        "last_updated": "2015-02-27",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "BAO",
        "authorized_official_middle_name": "THAI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "424-488-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A95636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Elizabeth Bonilla
• Whitney Boole Williams, LMFT
• Samantha Bordener, DDS
• Cassandra L Bowles, PSYD
• Ashley Lauren Boyer, SLP
• Tristen Scott Bracken
• Kristine Taylor Brady, M.ED., BCBA
• Chad David Brinderson, PH.D.
• Laura Alongi Brinderson, LCSW
• Linda E. Brochert-Saker, M.F.T.

• Interventional Pain Medicine Physician in Hermosa Beach, CA
• Providers in Hermosa Beach, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; 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.