Active NPI
Brainhealth Solutions, Inc.
- Psychiatry Physician
- Costa Mesa, CA
National Provider Identifier
1649815267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- BRAINHEALTH SOLUTIONS, INC.
- Practice address
- 3151 Airway Ave BLDG R
Costa Mesa, CA 92626-4607 - Phone
- (949) 288-5377
- Fax
- (774) 209-4466
- NPI assigned
- Nov 7, 2019
- Last updated
- Aug 2, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert G Bota, MD
- Title
- President
- Phone
- (229) 815-0219
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | NU | Primary |
Addresses
Primary practice location
3151 Airway Ave BLDG R
Costa Mesa, CA 92626-4607
Mailing address
30310 Rancho Viejo Rd
San Juan Capistrano, CA 92675-1576
Phone (949) 288-5377
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
3151 Airway Ave
Ste R
Costa Mesa, CA 92626
Phone (949) 288-5377
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Registered Nurse
- Hawaiian Gardens, CA
- NPI 1124294145
-
- Psychiatry Physician
- Colton, CA
- NPI 1528528296
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573084800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1659398400000",
"number": "1649815267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30310 RANCHO VIEJO RD",
"city": "SAN JUAN CAPISTRANO",
"state": "CA",
"postal_code": "926751576",
"telephone_number": "949-288-5377",
"fax_number": "774-209-4466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3151 AIRWAY AVE BLDG R",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926264607",
"telephone_number": "949-288-5377",
"fax_number": "774-209-4466"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRAINHEALTH SOLUTIONS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2019-11-07",
"last_updated": "2022-08-02",
"certification_date": "2022-08-02",
"status": "A",
"authorized_official_last_name": "BOTA",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "229-815-0219",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.