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Organization
TRI VALLEY UROLOGY
Active
Organization
TRI VALLEY UROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP P BRODAK MD (PARTNER)
(951) 698-1901
Entity
Organization
Contact information
Practice address
521 E ELDER ST, SUITE 201, FALLBROOK, CA 92028-3081
(951) 698-1901
(951) 698-1074
Mailing address
25495 MEDICAL CENTER DR, SUITE 204, MURRIETA, CA 92562-4902
(951) 698-1901
(951) 698-1074
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/26/2012
Last updated
09/08/2021
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