Individual
DR. DERALD E BRACKMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2100 W 3RD ST STE 111, LOS ANGELES, CA 90057-1999
(213) 483-9930
(213) 483-0905
Mailing address
2100 W 3RD ST STE 111, LOS ANGELES, CA 90057-1999
(213) 483-9930
(213) 483-0905
Taxonomy
Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
Primary
G11124
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G111240
—
CA
Enumeration date
08/09/2006
Last updated
09/03/2013
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