Christian National Church

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

CHRISTIAN NATIONAL CHURCH

Doing business as

Chaplain serve and protect
Diplomatic security services age cy
Diplomatic security services provider and pharmacy7 more in Other names

Practice address

1350 E Chapman Ave
Fullerton, CA 92834-7400

Phone

(425) 387-7233

NPI assigned

Jan 31, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Bryant Lamont Ball, MD

Title

Officer/Provider

Phone

(425) 387-7233

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 10

• Chaplain serve and protect Doing business as
• Diplomatic security services age cy Doing business as
• Diplomatic security services provider and pharmacy Doing business as
• National Association of law enforcement explorers agency Doing business as
• Presidential service badge holder agency Doing business as
• Presidential service officer agency Doing business as
• diplomatic immunity agency Doing business as
• diplomatic security services-Special Agent Physician and Pharmacy Doing business as
• national association of law enforcement explorers of the christian nat Doing business as
• the firm Doing business as

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620864000000",
    "number": "1922639590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GENERAL DELIVERY",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928349999",
            "telephone_number": "425-387-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E CHAPMAN AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928347400",
            "telephone_number": "425-387-7233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6037 W Wabansia Ave # 1",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606393948",
            "country_code": "US",
            "telephone_number": "425-387-7233 x1",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHRISTIAN NATIONAL CHURCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-31",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A",
        "authorized_official_last_name": "BALL",
        "authorized_official_first_name": "BRYANT",
        "authorized_official_middle_name": "LAMONT",
        "authorized_official_title_or_position": "OFFICER/PROVIDER",
        "authorized_official_telephone_number": "425-387-7233",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "202C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Independent Medical Examiner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105384465",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chaplain serve and protect",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Diplomatic security services age cy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Diplomatic security services provider and pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "National Association of law enforcement explorers agency",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Presidential service badge holder agency",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Presidential service officer agency",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "diplomatic immunity agency",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "diplomatic security services-Special Agent Physician and Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "national association of law enforcement explorers of the christian nat",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "the firm",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "the firm",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Emergency Medicine Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; 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.