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Individual
MICHAEL PHILIPPE BROUSSEAU
Active
Individual
MICHAEL PHILIPPE BROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G081370
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB234617
MEDICARE PROVIDER NUMBER
—
Enumeration date
07/10/2006
Last updated
07/23/2015
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