Individual provider Active NPI

Robert Frits Brunst, MD PHD

  • Family Medicine Physician
  • Encinitas, CA
National Provider Identifier
1639257546
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G36956 Issued in CA
Practice address
477 N El Camino Real
Ste A200
Encinitas, CA 92024
Phone
(760) 942-1242
Fax
(760) 942-7840
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G36956 CA Primary

Addresses

Primary practice location

477 N El Camino Real
Ste A200
Encinitas, CA 92024

Mailing address

477 N El Camino Real
Ste A200
Encinitas, CA 92024
Phone (760) 942-1242

Other identifiers 2

IdentifierTypeStateIssuer
G369560MedicaidCA
5127318OtherMCAC PIN

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
Doctor of Medicine, Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639257546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL",
            "address_2": "STE A200",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "760-942-1242",
            "fax_number": "760-942-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL",
            "address_2": "STE A200",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "760-942-1242",
            "fax_number": "760-942-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNST",
        "first_name": "ROBERT",
        "middle_name": "FRITS",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G36956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G369560",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCAC PIN",
            "identifier": "5127318",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.