Individual
PAMELA BROSKA
Active
Individual
PAMELA BROSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
G61351
CA
207NS0135X
Procedural Dermatology Physician
G61351
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G613512
INDIVIDUAL PTAN
CA
01
—
070013862
RAILROAD MEDICARE
CA
Enumeration date
05/16/2006
Last updated
06/13/2013
Update your record
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