Individual provider Active NPI

Brenton Gregory Davis, MD

  • Internal Medicine Physician
  • Newport Beach, CA
National Provider Identifier
1760019897
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A186701 Issued in CA
Practice address
500 Superior Ave Ste 100
Newport Beach, CA 92663-3660
Phone
(803) 212-8740
Fax
(949) 764-7585
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A186701 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

500 Superior Ave Ste 100
Newport Beach, CA 92663-3660

Mailing address

500 Superior Ave Ste 100
Suite 100
Newport Beach, CA 92663-3660
Phone (949) 698-1339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240729004454 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7214474014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A186701CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1760019897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SUPERIOR AVE STE 100",
            "address_2": "SUITE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633660",
            "telephone_number": "949-698-1339",
            "fax_number": "949-764-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SUPERIOR AVE STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633660",
            "telephone_number": "803-212-8740",
            "fax_number": "949-764-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRENTON",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A186701",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.