Active NPI
Jonathan Leonard Brand, M.D., a Medical Corporation
- Addiction Psychiatry Physician
- Lynwood, CA
National Provider Identifier
1659641702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Psychiatry Physician
- License
- G50045
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Psychiatry Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G500451 | Medicaid | CA |
National Provider Directory
National Provider DirectoryNPI 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.