Organization
TRI VALLEY UROLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP P BRODAK MD (PARTNER)
(951) 698-1901
Entity
Organization
Contact information
Practice address
25495 MEDICAL CENTER DR, 204, MURRIETA, CA 92562-4902
(951) 698-1901
(951) 698-1074
Mailing address
25495 MEDICAL CENTER DR, 204, MURRIETA, CA 92562-4902
(951) 698-1901
(951) 698-1074
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
09/25/2006
Last updated
09/08/2021
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