Mark a. Brim, D.P.M., Inc.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E1542 Issued in CA

Legal business name

MARK A. BRIM, D.P.M., INC.

Practice address

17200 Ventura Blvd.
Suite 207
Encino, CA 91316-2804

Phone

(818) 783-3338

Fax

(818) 583-1444

NPI assigned

Jan 18, 2007

Last updated

Jul 30, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark A. Brim, D.P.M.

Title

President

Phone

(818) 783-3338

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375142400000",
    "number": "1861545576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17200 VENTURA BLVD",
            "address_2": "SUITE 207",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164005",
            "telephone_number": "818-783-3338",
            "fax_number": "818-583-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17200 VENTURA BLVD.",
            "address_2": "SUITE 207",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162804",
            "telephone_number": "818-783-3338",
            "fax_number": "818-583-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. BRIM, D.P.M., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2013-07-30",
        "status": "A",
        "authorized_official_last_name": "BRIM",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-783-3338",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E1542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E15420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Encino, CA
• Providers in Encino, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; 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.