MEDICARE: MADI BRAWER

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	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1710560727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADI BRAWER

Provider Business Mailing Address
First Line	:	531 ROBINSON DR
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92782-0910
Country	:	US
Telephone Number	:	562-305-7607
Fax Number	:

Provider Business Practice Location Address
First Line	:	7910 FROST ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-2771
Country	:	US
Telephone Number	:	858-966-6710
Fax Number	:

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

Provider Enumeration Date	:	04/28/2021
Last Update Date	:	04/28/2021

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Directions to “ MADI BRAWER ” Practice Location

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