JOHN DAVID BRANCH DO NPI 1174510309

NPI Information

NPI: 1174510309
Provider Name: JOHN DAVID BRANCH, DO
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
PECOS Registration: Yes
CLIA Number: 05D0708671
Address: 4646 BROCKTON AVE
SUITE 202
RIVERSIDE, CA
ZIP 92506
Phone: (951) 774-2952

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NPI Details

John David Branch, DO is a family medicine in Riverside, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. John David Branch, DO NPI is 1174510309. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4646 BROCKTON AVE
SUITE 202
RIVERSIDE, CA
ZIP 92506-102
Phone: (951) 774-2952
Fax: (951) 774-2955

The NPI 1174510309 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 05D0708671 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

The enumeration date for this NPI number is 10/3/2005 and was last updated on 6/4/2010.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		20A5212	CALIFORNIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	E08899	MEDICARE ID-TYPE UNSPECIFIED

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: 11/21/2025

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