Organization Active NPI

West Coast Brain and Spine Institute Inc

  • Specialist
  • Santa Ana, CA
National Provider Identifier
1649434770
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A63188 Issued in CA
Legal business name
WEST COAST BRAIN AND SPINE INSTITUTE INC
Practice address
999 N Tustin Ave Ste 109
Santa Ana, CA 92705-6504
Phone
(310) 914-9150
Fax
(310) 914-9705
NPI assigned
Jul 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Authorized official

Name
Dr. Peyman R Tabrizi, M.D.NPI 1154362499
Title
Medical Doctor
Phone
(323) 914-9150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A63188 CA Primary

Addresses

Primary practice location

999 N Tustin Ave Ste 109
Santa Ana, CA 92705-6504

Mailing address

999 N Tustin Ave Ste 109
Santa Ana, CA 92705-6504
Phone (310) 914-9150

Other identifiers 1

IdentifierTypeStateIssuer
00A631880MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151019000159 CA Part B Supplier - Clinic/Group Practice 2860701653 Receives reassigned benefits from 4 practitioners
Practice locations: Salinas, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1649434770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 N TUSTIN AVE STE 109",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927056504",
            "telephone_number": "310-914-9150",
            "fax_number": "310-914-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 N TUSTIN AVE STE 109",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927056504",
            "telephone_number": "310-914-9150",
            "fax_number": "310-914-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST BRAIN AND SPINE INSTITUTE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "TABRIZI",
        "authorized_official_first_name": "PEYMAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "323-914-9150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A63188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A631880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.