Kevin W. Broder, M. D. Incorporated

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A82409 Issued in CA

Legal business name

KEVIN W. BRODER, M. D. INCORPORATED

Practice address

8899 University Center LN
Suite 350
San Diego, CA 92122-1013

Phone

(858) 453-5344

NPI assigned

Oct 30, 2008

Last updated

Oct 30, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Broder, MDNPI 1205885902

Title

President

Phone

(858) 453-5344

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin Wayne Broder, MD

  • Plastic Surgery Physician
  • San Diego, CA
  • NPI 1205885902
  NPD (past) Authorized official

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225324800000",
    "number": "1336392604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 LEBON DR",
            "address_2": "UNIT 3204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921224593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8899 UNIVERSITY CENTER LN",
            "address_2": "SUITE 350",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221013",
            "telephone_number": "858-453-5344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN W. BRODER, M. D. INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-30",
        "last_updated": "2008-10-30",
        "status": "A",
        "authorized_official_last_name": "BRODER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-453-5344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A82409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Stevens DC a Professional Chiropractic Corporation
• Kevin T. Murphy, MD a Professional Corporation (PeakPerformance Center)
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• Kevin T. Toliver, M.D., Inc.
• Kevin Tan DDS Inc
• Kevory Enterprises, Inc (Senior Helpers)
• Darneil Eugene Key
• Andrew Robert Keyes, M.D.
• Kara Alana Keyes, CRNA
• Ashlee Keys, RN

• Plastic Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; 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.