Gene M. Broth, M.D., Inc.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

C026169 Issued in CA

Legal business name

GENE M. BROTH, M.D., INC.

Practice address

2925 Sycamore Drive
Ste. 201
Simi Valley, CA 93065

Phone

(805) 522-0333

Fax

(805) 522-4230

NPI assigned

Oct 22, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gene M Broth, M.D.

Title

President

Phone

(805) 522-0333

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1063601474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 SYCAMORE DRIVE",
            "address_2": "STE. 201",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "93065",
            "telephone_number": "805-522-0333",
            "fax_number": "805-522-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 SYCAMORE DRIVE",
            "address_2": "STE. 201",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "93065",
            "telephone_number": "805-522-0333",
            "fax_number": "805-522-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENE M. BROTH, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "BROTH",
        "authorized_official_first_name": "GENE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-522-0333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "C026169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.