Active NPI
Michael I. Brodsky, M.D.
- Psychiatry Physician
- Los Angeles, CA
National Provider Identifier
1336229533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A74407
- Practice address
- 11080 W Olympic Blvd
Los Angeles, CA 90064-1937 - Phone
- (310) 966-6500
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A74407 | CA | Primary |
Addresses
Primary practice location
11080 W Olympic Blvd
Los Angeles, CA 90064-1937
Mailing address
PO Box 64334
Los Angeles, CA 90064-0334
Phone (310) 488-6551
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74407 | CA | MD | Pharmacist |
| A74407 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336229533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 64334",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900640334",
"telephone_number": "310-488-6551",
"fax_number": "310-388-0937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11080 W OLYMPIC BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900641937",
"telephone_number": "310-966-6500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODSKY",
"first_name": "MICHAEL",
"middle_name": "I.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A74407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.