Active NPI
Brooke Sandvig
- Physician Assistant
- Newport Beach, CA
National Provider Identifier
1487254736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 59800
- Practice address
- 3501 Jamboree Rd Ste 1250
Newport Beach, CA 92660-2959 - Phone
- (949) 988-7800
- NPI assigned
- Oct 27, 2020
- Last updated
- Aug 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 59800 | CA | Primary |
Addresses
Primary practice location
3501 Jamboree Rd Ste 1250
Newport Beach, CA 92660-2959
Mailing address
3501 Jamboree Rd Ste 1250
Newport Beach, CA 92660-2959
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59800 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628380800000",
"number": "1487254736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3501 JAMBOREE RD STE 1250",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 JAMBOREE RD STE 1250",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602959",
"telephone_number": "949-988-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDVIG",
"first_name": "BROOKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-27",
"last_updated": "2021-08-08",
"certification_date": "2021-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "59800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.