Individual provider Active NPI

Bryan Michael-Paul Spann, D.O.

  • Neurology Physician
  • Los Angeles, CA
National Provider Identifier
1679500912
Registry record updated Oct 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
20A7370 Issued in CA
Practice address
1520 San Pablo St
Suite 3000
Los Angeles, CA 90033-5310
Phone
(323) 442-5710
Fax
(323) 442-5729
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 20A7370 CA Primary

Addresses

Primary practice location

1520 San Pablo St
Suite 3000
Los Angeles, CA 90033-5310

Mailing address

File #57454
Los Angeles, CA 90074-0001
Phone (323) 442-5710

Other identifiers 1

IdentifierTypeStateIssuer
00AX73700MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A7370CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Neurologists, Inc. Past Accepting new patients
TMH Physician Organization Family Medicine PastSince Aug 8, 2021 Accepting new patients
Rancho Faculty Medical Associates, Inc. Past Accepting new patients
Arizona Post-Acute Medical Services 1 PC Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191801600000",
    "number": "1679500912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE #57454",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740001",
            "telephone_number": "323-442-5710",
            "fax_number": "323-442-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST",
            "address_2": "SUITE 3000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335310",
            "telephone_number": "323-442-5710",
            "fax_number": "323-442-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANN",
        "first_name": "BRYAN",
        "middle_name": "MICHAEL-PAUL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "20A7370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX73700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2007; 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.