Active NPI
Karen Eiko Brodersen, PHARM.D.
- Pharmacist
- Marina del Rey, CA
National Provider Identifier
1306132824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26640
- Practice address
- 13463 Washington Blvd
Marina del Rey, CA 90292-5658 - Phone
- (310) 754-2002
- Fax
- (310) 754-2010
- NPI assigned
- Jun 22, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26640 | CA | Primary |
Addresses
Primary practice location
13463 Washington Blvd
Marina del Rey, CA 90292-5658
Mailing address
3125 Granville Ave
Los Angeles, CA 90066-1114
Phone (310) 398-1898
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26640 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308700800000",
"number": "1306132824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3125 GRANVILLE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900661114",
"telephone_number": "310-398-1898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13463 WASHINGTON BLVD",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902925658",
"telephone_number": "310-754-2002",
"fax_number": "310-754-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODERSEN",
"first_name": "KAREN",
"middle_name": "EIKO",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-22",
"last_updated": "2011-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "26640",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marina del Rey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.