Individual provider Active NPI

Bradford S Curtis, MD

  • Pediatrics Physician
  • Fountain Valley, CA
National Provider Identifier
1932190568
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G079617 Issued in CA
Practice address
11420 Warner Ave
Fountain Valley, CA 92708-2529
Phone
(714) 549-1300
NPI assigned
Nov 2, 2005
Last updated
Apr 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G079617 CA Primary

Addresses

Primary practice location

11420 Warner Ave
Fountain Valley, CA 92708-2529

Mailing address

2742 Dow Ave
Tustin, CA 92780-7242
Phone (657) 241-3592

Other identifiers 1

IdentifierTypeStateIssuer
00G796170MedicaidCA

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
I20040226000718 CA Practitioner - Pediatric Medicine 2668368556 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G079617CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Pediatrics CurrentSince Feb 1, 2011 Accepting new patients
Bristol Park Medical Group, Inc Pediatrics Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

11420 Warner Ave
Fountain Vly, CA 92708
Phone (714) 549-1300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

23512 Madero
Mission Viejo, CA 92691
Phone (949) 583-1600

26991 Crown Valley Pkwy
Mission Viejo, CA 92691
Phone (949) 393-5426

2742 Dow Ave
Tustin, CA 92780
Phone (714) 665-1600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1932190568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2742 DOW AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807242",
            "telephone_number": "657-241-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11420 WARNER AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082529",
            "telephone_number": "714-549-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CURTIS",
        "first_name": "BRADFORD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G079617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G796170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.