Healthcare Provider Details

I. General information

NPI: 1164986766
Provider Name (Legal Business Name): DEBBIE BROSTOFF PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBBIE GARCIA

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 4TH ST
SAN FRANCISCO CA
94143-2351
US

IV. Provider business mailing address

4650 W SUNSET BLVD
LOS ANGELES CA
90027-6062
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1352
  • Fax:
Mailing address:
  • Phone: 213-456-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberNP95009810
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number95009810
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: