Organization Active NPI

The Adolescent and Children's Orthopedic Surgeons

Doing business as Family Orthopedic and Rehabilitation Center Encino

  • Pediatric Orthopaedic Surgery Physician
  • Encino, CA
National Provider Identifier
1851446132
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
A79821 Issued in CA
Legal business name
THE ADOLESCENT AND CHILDREN'S ORTHOPEDIC SURGEONS
Doing business as
Family Orthopedic and Rehabilitation Center Encino
Practice address
5353 Balboa Blvd
Suite 202
Encino, CA 91316-2804
Phone
(818) 789-9449
Fax
(818) 789-9339
NPI assigned
Jan 24, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Keith Richard Brookenthal, MDNPI 1437118163
Title
Medical Director
Phone
(818) 789-9449

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XP3100X A79821 CA Primary

Addresses

Primary practice location

5353 Balboa Blvd
Suite 202
Encino, CA 91316-2804

Mailing address

5353 Balboa Blvd
Suite 202
Encino, CA 91316-2804
Phone (818) 789-9449

Other names 1

  • Family Orthopedic and Rehabilitation Center Encino Doing business as

National Provider Directory

National Provider Directory

Locations

351 Rolling Oaks Dr
Ste 104
Thousand Oaks, CA 91361
Phone (805) 491-4008

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851446132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 BALBOA BLVD",
            "address_2": "SUITE 202",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162804",
            "telephone_number": "818-789-9449",
            "fax_number": "818-789-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 BALBOA BLVD",
            "address_2": "SUITE 202",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162804",
            "telephone_number": "818-789-9449",
            "fax_number": "818-789-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ADOLESCENT AND CHILDREN'S ORTHOPEDIC SURGEONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROOKENTHAL",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-789-9449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "CA",
            "license": "A79821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Orthopedic and Rehabilitation Center Encino",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.