Basic Information
| Provider Information | |||||||||
| NPI: | 1972973501 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ONE BRAIN AND SPINE PHYSICIANS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 361 HOSPITAL RD | ||||||||
| Address2: | SUITE 224 | ||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926633522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493834190 | ||||||||
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| Practice Location | |||||||||
| Address1: | 361 HOSPITAL RD | ||||||||
| Address2: | SUITE 224 | ||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926633522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493834190 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2015 | ||||||||
| LastUpdateDate: | 12/01/2015 | ||||||||
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| AuthorizedOfficialLastName: | OZGUR | ||||||||
| AuthorizedOfficialFirstName: | BURAK | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 9493834190 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0117X | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | 207T00000X | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.