Individual provider Active NPI

Jonathan L Brand, MD

  • Psychiatry Physician
  • Lynwood, CA
National Provider Identifier
1548259401
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G50045 Issued in CA
Practice address
3630 E Imperial Hwy
Lynwood, CA 90262-2609
Phone
(310) 900-8662
Fax
(424) 400-7749
NPI assigned
Oct 13, 2005
Last updated
Dec 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G50045 CA Primary

Addresses

Primary practice location

3630 E Imperial Hwy
Lynwood, CA 90262-2609

Mailing address

PO Box 4570
Palos Verdes Peninsula, CA 90274-9607
Phone (424) 400-7748

Other identifiers 2

IdentifierTypeStateIssuer
120523OtherCALA CO MENTAL HEALTH
00G500451MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160506002040 CA Practitioner - Psychiatry 1456246354 Reassigns benefits to 2 organizations
Practice locations: Lynwood, CA; Torrance, CA; Long Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Utah School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23700 Camino del Sol
Torrance, CA 90505-5017
Phone (310) 530-1151

2600 Redondo Ave
Suite 500
Long Beach, CA 90806-2325
Phone (562) 304-1740

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G50045CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central City Community Health Center Inc CurrentSince Oct 22, 2019 Accepting new patients
Central City Community Health Center Inc CurrentSince Oct 22, 2019 Accepting new patients
Kamal Bijanpour Inc Psychiatry Past Accepting new patients

Locations

5970 S Central Ave
Los Angeles, CA 90001
Phone (213) 234-3280

2019 Saturn St
Monterey Park, CA 91755
Phone (323) 724-0019

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1548259401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4570",
            "city": "PALOS VERDES PENINSULA",
            "state": "CA",
            "postal_code": "902749607",
            "telephone_number": "424-400-7748",
            "fax_number": "424-400-7749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 E IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622609",
            "telephone_number": "310-900-8662",
            "fax_number": "424-400-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAND",
        "first_name": "JONATHAN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G50045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA CO MENTAL HEALTH",
            "identifier": "120523",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G500451",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.