MEDICARE: DR. STEVEN ANDREW BRODY M.D.

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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	G47356	CA
2	207VE0102X	Reproductive Endocrinology Physician	G47356	CA

General Provider Information

NPI Number	:	1265558266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN ANDREW BRODY M.D.

Provider Business Mailing Address
First Line	:	7514 GIRARD AVE
Second Line	:	SUITE 201
City	:	LA JOLLA
State	:	CA
Zip	:	92037-5149
Country	:	US
Telephone Number	:	619-265-1800
Fax Number	:	858-453-8587

Provider Business Practice Location Address
First Line	:	8899 UNIVERSITY CENTER LN
Second Line	:	SUITE 100
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-1013
Country	:	US
Telephone Number	:	619-265-1800
Fax Number	:	858-453-8587

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	11/20/2008

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