NPIMap

Organization Active NPI

Gary Brazina MD, Inc.

  • Specialist
  • Marina del Rey, CA
National Provider Identifier
1992942254
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G37830 Issued in CA
Legal business name
GARY BRAZINA MD, INC.
Practice address
13160 Mindanao Way Ste 300
Marina del Rey, CA 90292-6393
Phone
(310) 821-2222
Fax
(310) 823-5871
NPI assigned
Jan 8, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Authorized official

Name
Dr. Gary E Brazina, M.D.
Title
President/Owner
Phone
(310) 821-2222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G37830 CA Primary

Addresses

Primary practice location

13160 Mindanao Way Ste 300
Marina del Rey, CA 90292-6393

Mailing address

13160 Mindanao Way Ste 300
Marina del Rey, CA 90292-6393
Phone (310) 821-2222

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1992942254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13160 MINDANAO WAY STE 300",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926393",
            "telephone_number": "310-821-2222",
            "fax_number": "310-823-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13160 MINDANAO WAY STE 300",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926393",
            "telephone_number": "310-821-2222",
            "fax_number": "310-823-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY BRAZINA MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "BRAZINA",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "310-821-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G37830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.