Organization Active NPI

The de Brito Professional Medical Corporation

  • Clinical Neuropsychologist
  • Pasadena, CA
National Provider Identifier
1790098978
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
A66604 Issued in CA
Legal business name
THE DE BRITO PROFESSIONAL MEDICAL CORPORATION
Practice address
751 N Fair Oaks Ave
301
Pasadena, CA 91103-3069
Phone
(626) 405-4001
Fax
(818) 301-7443
NPI assigned
Jul 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Authorized official

Name
Dr. Dirk De Brito, MD, MPH
Title
President
Phone
(310) 717-0069

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X A66604 CA Primary
Exclusive Provider Organization 302F00000X G64523 CA
Preferred Provider Organization 305R00000X PSY26446 CA

Addresses

Primary practice location

751 N Fair Oaks Ave
301
Pasadena, CA 91103-3069

Mailing address

PO Box 247
Pasadena, CA 91102-0247
Phone (626) 405-4001

National Provider Directory

National Provider Directory

Locations

301 E Colorado Blvd
Ste 628
Pasadena, CA 91101
Phone (626) 405-4001

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1790098978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911020247",
            "telephone_number": "626-405-4001",
            "fax_number": "818-301-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 N FAIR OAKS AVE",
            "address_2": "301",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911033069",
            "telephone_number": "626-405-4001",
            "fax_number": "818-301-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DE BRITO PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "DE BRITO",
        "authorized_official_first_name": "DIRK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-717-0069",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "A66604",
            "primary": true
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "G64523",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "PSY26446",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.