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General NPI Number Information
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NPI Number | 1699192286
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Entity Type | Individual
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Provider Name | JEFFREY BRODOVSKY DO
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Gender | Male
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Dates
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Enumeration Date | 03/21/2014
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 2800 L ST STE 500
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City | SACRAMENTO
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State | CA
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Zip | 95816-5616
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Country | US
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Telephone | 916-454-6850
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Fax | 916-454-6852
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Provider Business Mailing Address
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Address Line | PO BOX 255228
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City | SACRAMENTO
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State | CA
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Zip | 95865-5228
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Country | US
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Telephone | 916-454-6850
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Fax |
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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 | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 20A16385
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 20A16385
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License Number State | CA
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