Benjamin Broukhim M.D. a Medical Corp

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

A37198 Issued in CA

Legal business name

BENJAMIN BROUKHIM M.D. A MEDICAL CORP

Practice address

11650 Riverside Dr
Second Floor
North Hollywood, CA 91602-1093

Phone

(818) 755-6070

Fax

(818) 755-1870

NPI assigned

Aug 19, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Broukhim, M.D.NPI 1073573283

Title

Medical Director

Phone

(818) 755-6070

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin Broukhim, M.D.

  • Orthopaedic Surgery Physician
  • North Hollywood, CA
  • NPI 1073573283
  Medicare reassignment NPD Authorized official
• Blake Johnathan Broukhim, LAC

  • Acupuncturist
  • North Hollywood, CA
  • NPI 1427921378
  NPD (past)

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409270400000",
    "number": "1962659151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11650 RIVERSIDE DR",
            "address_2": "SECOND FLOOR",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916021093",
            "telephone_number": "818-755-6070",
            "fax_number": "818-755-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11650 RIVERSIDE DR",
            "address_2": "SECOND FLOOR",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916021093",
            "telephone_number": "818-755-6070",
            "fax_number": "818-755-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN BROUKHIM M.D. A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2014-08-29",
        "status": "A",
        "authorized_official_last_name": "BROUKHIM",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-755-6070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A37198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A37198",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Paola Benavente, MA
• Johnathon Alexander Bendy
• Beneficent Care Hospice Inc
• Lynne Suzanne Benhabib
• Maria Benitez
• Marissa Ann Bennett, M.A.
• Hayarpi Berberyan, RPH
• Christopher David Berens
• Christal Bergado, FNP-C
• Eric Bergemann

• Orthopaedic Surgery Physician in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.