Organization
KEVIN W. BRODER, M. D. INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN BRODER MD (PRESIDENT)
(858) 453-5344
Entity
Organization
Contact information
Practice address
8899 UNIVERSITY CENTER LN, SUITE 350, SAN DIEGO, CA 92122-1013
(858) 453-5344
Mailing address
3535 LEBON DR, UNIT 3204, SAN DIEGO, CA 92122-4593
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A82409
CA
Other
Enumeration date
10/30/2008
Last updated
10/30/2008
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