Active NPI
Mark B. Braunstein, MD Inc
- Family Medicine Physician
- Sherman Oaks, CA
National Provider Identifier
1760723480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G64033
- Legal business name
- MARK B. BRAUNSTEIN, MD INC
- Practice address
- 4849 Van Nuys Blvd
Ste 105
Sherman Oaks, CA 91403-2110 - Phone
- (818) 905-9598
- Fax
- (818) 905-0130
- NPI assigned
- Mar 5, 2013
- 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
- Mark B Braunstein, MD
- Title
- MD, President
- Phone
- (818) 905-9598
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G64033 | CA | Primary |
Addresses
Primary practice location
4849 Van Nuys Blvd
Ste 105
Sherman Oaks, CA 91403-2110
Mailing address
4849 Van Nuys Blvd
Ste 105
Sherman Oaks, CA 91403-2110
Phone (818) 905-9598
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G64033 | Other | CA | LICENSE |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2057679 | Mark B. Braunstein MD Inc | Certificate of waiver | Apr 21, 2027 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362441600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1362441600000",
"number": "1760723480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4849 VAN NUYS BLVD",
"address_2": "STE 105",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914032110",
"telephone_number": "818-905-9598",
"fax_number": "818-905-0130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4849 VAN NUYS BLVD",
"address_2": "STE 105",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914032110",
"telephone_number": "818-905-9598",
"fax_number": "818-905-0130"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARK B. BRAUNSTEIN, MD INC",
"organizational_subpart": "NO",
"enumeration_date": "2013-03-05",
"last_updated": "2013-03-05",
"status": "A",
"authorized_official_last_name": "BRAUNSTEIN",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "MD, PRESIDENT",
"authorized_official_telephone_number": "818-905-9598",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "CA",
"license": "G64033",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "G64033",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sherman Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.