Organization Active NPI

Brett a Gidney MD a Medical Corporation

  • Clinical Cardiac Electrophysiology Physician
  • San Diego, CA
National Provider Identifier
1679747448
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
A81336 Issued in CA
Legal business name
BRETT A GIDNEY MD A MEDICAL CORPORATION
Practice address
5555 Reservoir Dr
Suite 112
San Diego, CA 92120-5134
Phone
(619) 287-7060
NPI assigned
Apr 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Brett Andrew Gidney, MD
Title
President, Ceo
Phone
(619) 287-7060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0001X A81336 CA Primary

Addresses

Primary practice location

5555 Reservoir Dr
Suite 112
San Diego, CA 92120-5134

Mailing address

5555 Reservoir Dr
Suite 112
San Diego, CA 92120-5134
Phone (619) 287-7060

Other identifiers 1

IdentifierTypeStateIssuer
A81336OtherCASTATE LICENSE

National Provider Directory

National Provider Directory

Locations

5555 Reservoir Dr
Ste 112
San Diego, CA 92120
Phone (619) 287-7060

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1679747448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR",
            "address_2": "SUITE 112",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205134",
            "telephone_number": "619-287-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 RESERVOIR DR",
            "address_2": "SUITE 112",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205134",
            "telephone_number": "619-287-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRETT A GIDNEY MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "GIDNEY",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "619-287-7060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "A81336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A81336",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.