Individual
DR. LORI BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
8110 BIRMINGHAM WAY, SAN DIEGO, CA 92123-2758
(858) 966-5961
Mailing address
3020 CHILDRENS WAY, MC5003, SAN DIEGO, CA 92123-4223
(858) 309-6300
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
A106397
CA
208000000X
Pediatrics Physician
A106397
CA
Other
Enumeration date
06/20/2007
Last updated
03/14/2016
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