Individual
ANATOLY BRODSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 MERCED ST, INTERNAL MEDICINE DEPARTMENT, SAN LEANDRO, CA 94577-4201
(510) 454-4010
Mailing address
2500 MERCED ST, INTERNAL MEDICINE DEPARTMENT, SAN LEANDRO, CA 94577-4201
(510) 454-4010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A72800
CA
207Q00000X
Family Medicine Physician
MD22865
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080188871
RAILROAD MEDICARE PROVIDER NUMBER
OR
05
—
287049
—
OR
Enumeration date
05/12/2006
Last updated
12/15/2021
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