Provider Demographics
NPI:1033508718
Name:BRIAN BELNAP DO, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:BRIAN BELNAP DO, A MEDICAL CORPORATION
Other - Org Name:WEST COAST PAIN SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BELNAP
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:760-650-4040
Mailing Address - Street 1:4405 MANCHESTER AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-4940
Mailing Address - Country:US
Mailing Address - Phone:760-650-4040
Mailing Address - Fax:760-650-4057
Practice Address - Street 1:4405 MANCHESTER AVE STE 101
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-4940
Practice Address - Country:US
Practice Address - Phone:760-650-4040
Practice Address - Fax:760-650-4057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-17
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10439261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAVAD000Medicare UPIN
CAPTAN GF468Medicare PIN