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MARIO I. BRAKIN M.D.F.A.A.P. INC NPI 1164442620


NPI Information

NPI: 1164442620
Provider Name: MARIO I. BRAKIN, M.D.,F.A.A.P., INC

Doing Business As: PEDIATRIC ENDOCRINOLOGY ASSOCIATES

Classification: Pediatrics - 2080P0205X
Entity Type: Organization

Specialization: Pediatric Endocrinology

CLIA Number: 05D2090843

Address:
2650 ELM AVE STE 210
LONG BEACH, CA
ZIP 90806
Phone: (562) 595-0166
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MARIO I. BRAKIN, M.D.,F.A.A.P., INC is a pediatric endocrinology pediatrics in Long Beach, CA. The provider is a pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. MARIO I. BRAKIN, M.D.,F.A.A.P., INC NPI is 1164442620. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Pediatric Endocrinology Associates.

The provider's business location address is:

2650 ELM AVE STE 210
LONG BEACH, CA
ZIP 90806-600
Phone: (562) 595-0166
Fax: (562) 595-6714

The provider's authorized official is Mario Ignacio Brakin .
The authorized official title is President and has the following contact phone number (562) 595-0166.

The CLIA number assigned to this NPI record is 05D2090843 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/20/2006 and was last updated on 6/5/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0205XPediatricsPediatric EndocrinologyA81425CALIFORNIANo
22080P0205XPediatricsPediatric EndocrinologyA85298CALIFORNIANo
32080P0205XPediatricsPediatric EndocrinologyA33396CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR0100650MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAGROUP PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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