Provider Demographics
NPI:1427167121
Name:DOONAN, BRYAN CHARLES (MD)
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:CHARLES
Last Name:DOONAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:360 SAN MIGUEL DR STE 107
Mailing Address - Street 2:SUITE 307
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7815
Mailing Address - Country:US
Mailing Address - Phone:949-760-8300
Mailing Address - Fax:949-760-8316
Practice Address - Street 1:360 SAN MIGUEL DR STE 107
Practice Address - Street 2:SUITE 307
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7815
Practice Address - Country:US
Practice Address - Phone:949-760-8300
Practice Address - Fax:949-760-8316
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2018-04-17
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Provider Licenses
StateLicense IDTaxonomies
CAA78014207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I25404Medicare UPIN