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General NPI Number Information
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NPI Number | 1790598381
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Entity Type | Organization
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Legal Business Name | JERALYN BROSSFIELD M.D., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 72301 COUNTRY CLUB DR STE 105
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-8007
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Country | US
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Telephone | 760-567-8207
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Fax |
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Provider Business Mailing Address
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Address Line | 72301 COUNTRY CLUB DR STE 105
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-8007
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Country | US
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Telephone | 760-567-8207
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JERALYN BROSSFIELD
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Credential | MD
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Telephone | 769-691-2069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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