Healthcare Provider Details

I. General information

NPI: 1245163856
Provider Name (Legal Business Name): BROPAL MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33050 ANTELOPE RD STE 212
MURRIETA CA
92563-2491
US

IV. Provider business mailing address

2108 N ST STE N
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 877-340-1697
  • Fax:
Mailing address:
  • Phone: 877-340-1697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARY BOLDEN
Title or Position: CCO
Credential:
Phone: 877-340-1697