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NPI Code Detail

MEDICARE: PATRICIA SUE BRUBAKER RN

MEDICARE: PATRICIA SUE BRUBAKER RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WA2000XAdministrator Registered Nurse529341CA

General Provider Information

NPI Number : 1134378128
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA SUE BRUBAKER RN
Provider Business Mailing Address
First Line : 944 AVENIDA DE SAN CLEMENTE
Second Line :
City : ENCINITAS
State : CA
Zip : 92024-3935
Country : US
Telephone Number : 858-642-3242
Fax Number : 858-552-7520
Provider Business Practice Location Address
First Line : 3350 LA JOLLA VILLAGE DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92161-0002
Country : US
Telephone Number : 858-642-3242
Fax Number : 858-552-7520
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2008
Last Update Date : 09/15/2008

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Directions to “ PATRICIA SUE BRUBAKER RN” Practice Location

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