Individual
AUTUMN J BROADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
5730 TELEGRAPH AVE STE 117, OAKLAND, CA 94609-1710
(415) 600-6400
(415) 369-1384
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(415) 600-6400
(415) 369-1384
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
1046715
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A142657
STATE MEDICAL LICENSE
CA
Enumeration date
06/29/2009
Last updated
02/24/2021
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