Healthcare Provider Details

I. General information

NPI: 1154329209
Provider Name (Legal Business Name): FRANCISCO ABREU BRACHO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3291 LOMA VISTA RD SUITE 301 BLDG 340
VENTURA CA
93003-3099
US

IV. Provider business mailing address

PO BOX 631856
BALTIMORE MD
21263-1856
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-6120
  • Fax: 805-652-6136
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberG079747
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: