NPIMap

Organization Active NPI

Ivan L Breed MD Inc

  • Family Medicine Physician
  • Covina, CA
National Provider Identifier
1669478228
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A31294 Issued in CA
Legal business name
IVAN L BREED MD INC
Practice address
605 E Badillo St
Suite 110
Covina, CA 91723-2846
Phone
(626) 917-5999
Fax
(626) 917-5999
NPI assigned
Jun 28, 2005
Last updated
Apr 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Authorized official

Name
Ivan L Breed, MDNPI 1073539474
Title
President/Owner
Phone
(626) 917-5999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A31294 CA Primary

Addresses

Primary practice location

605 E Badillo St
Suite 110
Covina, CA 91723-2846

Mailing address

PO Box 4609
Covina, CA 91723-4609
Phone (626) 917-5999

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365638400000",
    "number": "1669478228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4609",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917234609",
            "telephone_number": "626-917-5999",
            "fax_number": "626-917-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 E BADILLO ST",
            "address_2": "SUITE 110",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917232846",
            "telephone_number": "626-917-5999",
            "fax_number": "626-917-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVAN L BREED MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2013-04-11",
        "status": "A",
        "authorized_official_last_name": "BREED",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "626-917-5999",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A31294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.