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General NPI Number Information
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NPI Number | 1811017536
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Entity Type | Organization
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Legal Business Name | JAMES W. BRODE, MD., INC.
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 07/27/2011
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Provider Practice Location Address
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Address Line | 7551 TIMBERLAKE WAY SUITE 240
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City | SACRAMENTO
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State | CA
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Zip | 95823-5420
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Country | US
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Telephone | 916-427-5881
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Fax | 916-427-8892
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Provider Business Mailing Address
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Address Line | 7551 TIMBERLAKE WAY SUITE 240
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City | SACRAMENTO
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State | CA
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Zip | 95823-5420
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Country | US
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Telephone | 916-427-5881
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Fax | 916-427-8892
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES WILLIAM BRODE
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Credential | M.D.
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Telephone | 916-427-5881
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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 | G278170
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License Number State | CA
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