Individual provider Active NPI

Berj K Minasakanian, MD

  • Emergency Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1861426850
Registry record updated Oct 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A29869 Issued in CA
Practice address
2701 S Bristol St
Santa Ana, CA 92704-0240
Phone
(714) 754-5454
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A29869 CA Primary

Addresses

Primary practice location

2701 S Bristol St
Santa Ana, CA 92704-0240

Mailing address

PO Box 20020
Fountain Valley, CA 92728-0020
Phone (562) 809-3564

Other identifiers 1

IdentifierTypeStateIssuer
00A298690MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040618000918 CA Practitioner - Internal MedicinePractitioner - Emergency Medicine 0840275517 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A29869CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59 LLC CurrentSince Jan 11, 2014 Accepting new patients
KND Development 59, LLC CurrentSince Jan 11, 2014 Accepting new patients
Acute Care Medical Coastal Emergency Medicine Past Accepting new patients
Continuum Medical Associates,a Professional Medical Corporation Emergency Medicine Past Accepting new patients

Locations

16453 Colorado Ave
Paramount, CA 90723
Phone (562) 408-7427

2224 Medical Center Dr
Perris, CA 92571
Phone (951) 436-3460

1901 College Ave
Santa Ana, CA 92706
Phone (714) 564-7800

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223856000000",
    "number": "1861426850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20020",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927280020",
            "telephone_number": "562-809-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 S BRISTOL ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927040240",
            "telephone_number": "714-754-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINASAKANIAN",
        "first_name": "BERJ",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A29869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A298690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.