Individual
JACQUELINE BROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
230 PROSPECT PL STE 260, CORONADO, CA 92118
(619) 437-1146
Mailing address
230 PROSPECT PL STE 260, CORONADO, CA 92118-1987
(619) 437-1146
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A160890
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2015
Last updated
02/25/2020
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