Organization Active NPI

Jonathan Leonard Brand, M.D., a Medical Corporation

  • Addiction Psychiatry Physician
  • Lynwood, CA
National Provider Identifier
1659641702
Registry record updated Feb 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
License
G50045 Issued in CA
Legal business name
JONATHAN LEONARD BRAND, M.D., A MEDICAL CORPORATION
Practice address
3630 E Imperial Hwy
Lynwood, CA 90262-2636
Phone
(310) 701-7830
Fax
(310) 645-5532
NPI assigned
Jan 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2013

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

Authorized official

Name
Dr. Jonathan Leonard Brand, M. D.
Title
Owner
Phone
(310) 306-6150

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0802X G50045 CA Primary
Psychiatric Hospital Unit 273R00000X CA

Addresses

Primary practice location

3630 E Imperial Hwy
Lynwood, CA 90262-2636

Mailing address

4314 Marina City Dr
Suite 1118CTS
Marina del Rey, CA 90292-5816
Phone (310) 306-6150

Other identifiers 1

IdentifierTypeStateIssuer
00G500451MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361491200000",
    "number": "1659641702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4314 MARINA CITY DR",
            "address_2": "SUITE 1118CTS",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925816",
            "telephone_number": "310-306-6150",
            "fax_number": "310-645-5532"
        },
        {
            "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": "902622636",
            "telephone_number": "310-701-7830",
            "fax_number": "310-645-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN LEONARD BRAND, M.D., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-06",
        "last_updated": "2013-02-22",
        "status": "A",
        "authorized_official_last_name": "BRAND",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "LEONARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-306-6150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CA",
            "license": "G50045",
            "primary": true
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G500451",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; 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.