Individual
ANDREA MARGARETTE BRAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3828 DELMAS TER, CULVER CITY, CA 90232-2713
(310) 202-4745
(310) 202-4168
Mailing address
POST OFFICE BOX 662046, ARCADIA, CA 91066-2046
(626) 447-0296
(626) 447-6057
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G73405
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G734050
—
CA
01
—
G73405
MEDICAL LICENSE
CA
Enumeration date
06/15/2006
Last updated
08/31/2012
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