Organization
BROAD MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LAUREN BROAD MD (CEO/PRESIDENT)
(949) 720-9848
Entity
Organization
Contact information
Practice address
1640 NEWPORT BLVD STE 300, COSTA MESA, CA 92627-7725
(949) 720-9848
(949) 720-9195
Mailing address
1640 NEWPORT BLVD STE 300, COSTA MESA, CA 92627-7725
(929) 720-9848
(949) 720-9195
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
05/10/2019
Last updated
09/06/2025
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