Organization Active NPI

Mark B. Braunstein, MD Inc

  • Family Medicine Physician
  • Sherman Oaks, CA
National Provider Identifier
1760723480
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G64033 Issued in CA
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

Updated by the provider on Mar 5, 2013

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
G64033OtherCALICENSE

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2057679Mark B. Braunstein MD Inc4849 Van Nuys Blvd, Ste 202, Sherman Oaks, CA 91403Certificate of waiverApr 21, 2027

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.