Active NPI
Brian S. Ota, D.C.
- Chiropractor
- Sunnyvale, CA
National Provider Identifier
1902080609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 23084
- Practice address
- 150 E Fremont Ave
Sunnyvale, CA 94087-3201 - Phone
- (408) 720-0941
- Fax
- (408) 720-0943
- NPI assigned
- Dec 18, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 23084 | CA | Primary |
Addresses
Primary practice location
150 E Fremont Ave
Sunnyvale, CA 94087-3201
Mailing address
1052 E El Camino Real
Sunnyvale, CA 94087-3754
Phone (408) 248-7960
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ40577Z | Other | CA | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23084 | CA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark E Gray DC Chiropractic Corp | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Sunnyvale, CA
- NPI 1376602094
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289174400000",
"number": "1902080609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1052 E EL CAMINO REAL",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940873754",
"telephone_number": "408-248-7960",
"fax_number": "408-554-0654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 E FREMONT AVE",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940873201",
"telephone_number": "408-720-0941",
"fax_number": "408-720-0943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTA",
"first_name": "BRIAN",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-18",
"last_updated": "2010-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "23084",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ40577Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sunnyvale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.