Brian I Watanabe, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

G83423 Issued in CA

Practice address

24953 Paseo de Valencia
Suite 15C
Laguna Hills, CA 92653-4342

Phone

(949) 770-9300

Fax

(949) 770-9310

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michael Jaroslav Stastny, DPM, a Professional Corporation

  • Foot & Ankle Surgery Podiatrist
  • Hacienda Heights, CA
  • NPI 1780108381
  NPD (past)
• Valley Anesthesiology Services

  • Anesthesiology Physician
  • Indio, CA
  • NPI 1063510501
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365379200000",
    "number": "1831262203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24953 PASEO DE VALENCIA",
            "address_2": "SUITE 15C",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534342",
            "telephone_number": "949-770-9300",
            "fax_number": "949-770-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24953 PASEO DE VALENCIA",
            "address_2": "SUITE 15C",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534342",
            "telephone_number": "949-770-9300",
            "fax_number": "949-770-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATANABE",
        "first_name": "BRIAN",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2013-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G83423",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G83423",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CS338Y",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATION NPI",
            "identifier": "1417286980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Livia Wang, PHARMD.
• Ruihua Wang
• Ti Ya Wang
• Valerie Want
• Jordan Ward
• Michael J Watanabe, MD
• Ryan Watanabe
• Lindsey Breanne Watkins
• Wave Imaging LLC
• Richard Wayne, LMFT

• Vascular Surgery Physician in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.