Organization Active NPI

Bryan Cassim Doo, M.D., a Medical Corporation

  • Medical Specialty Clinic/Center
  • Whittier, CA
National Provider Identifier
1962617332
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
A65648 Issued in CA
Legal business name
BRYAN CASSIM DOO, M.D., A MEDICAL CORPORATION
Practice address
9209 Colima Rd
Suite 4500
Whittier, CA 90605-1800
Phone
(951) 278-5590
Fax
(951) 272-9924
NPI assigned
May 11, 2007
Last updated
Aug 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Authorized official

Name
Bryan Cassim Doo, M.D.NPI 1962500058
Title
President
Phone
(951) 278-5590

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X A65648 CA Primary

Addresses

Primary practice location

9209 Colima Rd
Suite 4500
Whittier, CA 90605-1800

Mailing address

P.O. Box 77790
Corona, CA 92877-0126
Phone (951) 278-5590

Other identifiers 1

IdentifierTypeStateIssuer
00A656480MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111025000721 CA Part B Supplier - Clinic/Group Practice 1052584786 Receives reassigned benefits from 1 practitioner
Practice locations: Whittier, CA

National Provider Directory

National Provider Directory
Tax ID family
Bryan Cassim Doo MD a Medical Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

355 E Rincon St
Ste 105
Corona, CA 92879

9209 Colima Rd
Ste 4500
Whittier, CA 90605
Phone (562) 696-5088

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312416000000",
    "number": "1962617332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 77790",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928770126",
            "telephone_number": "951-278-5590",
            "fax_number": "951-272-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9209 COLIMA RD",
            "address_2": "SUITE 4500",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906051800",
            "telephone_number": "951-278-5590",
            "fax_number": "951-272-9924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN CASSIM DOO, M.D., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2011-08-04",
        "status": "A",
        "authorized_official_last_name": "DOO",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "CASSIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-278-5590",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A65648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A656480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.