Edwin E Breitenbach, M.D.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

GFE16157 Issued in CA

Practice address

2601 Augusta
Tustin, CA 92782-1201

Phone

(714) 730-0087

NPI assigned

Jul 1, 2010

Last updated

Jul 1, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

State licenses

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1871804187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 AUGUSTA",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821201",
            "telephone_number": "714-730-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 AUGUSTA",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821201",
            "telephone_number": "714-730-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREITENBACH",
        "first_name": "EDWIN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-01",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "GFE16157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasleen K Brar, DDS
• Belinda Bravo
• Lydia Anna Bray
• Breakthrough Services LLC
• Laurel Bredthauer, MSW, ASW
• Juliet Brennan
• Tamara Sue Brenner, PH.D.
• Tram Bresnan
• Laura J Bretado, FNP-C
• Brett P Bowman O D Associates P S

• Facial Plastic Surgery Physician in Tustin, CA
• Providers in Tustin, CA by specialty
• Facial Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.