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General NPI Number Information
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NPI Number | 1275538423
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Entity Type | Individual
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Provider Name | MICHAEL A BRODSKY MD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 801 N TUSTIN AVE SUITE 706
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City | SANTA ANA
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State | CA
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Zip | 92705-3612
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Country | US
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Telephone | 714-568-6600
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Fax | 714-245-0260
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Provider Business Mailing Address
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Address Line | 801 N TUSTIN AVE #706
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City | SANTA ANA
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State | CA
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Zip | 92705-3612
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Country | US
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Telephone | 714-568-6600
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Fax | 714-245-0260
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD11837
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | MD11837
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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