Brain and Spine Institute of California, Inc.

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

A135941 Issued in CA

Legal business name

BRAIN AND SPINE INSTITUTE OF CALIFORNIA, INC.

Practice address

4631 Teller Ave Ste 100
Newport Beach, CA 92660-8105

Phone

(949) 335-7500

Fax

(949) 335-7500

NPI assigned

Jun 30, 2011

Organization subpart

No

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

Authorized official

Name

Gowriharan Thaiyananthan, M.D.

Title

President

Phone

(203) 376-6364

Specialties & licenses 6

Addresses

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1972890796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 TELLER AVE STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608105",
            "telephone_number": "949-335-7500",
            "fax_number": "949-387-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 TELLER AVE STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608105",
            "telephone_number": "949-335-7500",
            "fax_number": "949-335-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN AND SPINE INSTITUTE OF CALIFORNIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-30",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "THAIYANANTHAN",
        "authorized_official_first_name": "GOWRIHARAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-376-6364",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A103609",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A31505",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A80845",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A99924",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A135941",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A130152",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cory Lynne Brame, M.D.
• Julie Hines Branch, RNFA

• Orthopaedic Surgery of the Spine Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Orthopaedic Surgery of the Spine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; 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.