Dr Jeff Broffman a Medical Corp

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G53420 Issued in CA

Legal business name

DR JEFF BROFFMAN A MEDICAL CORP

Practice address

1144 Sonoma Ave
#101
Santa Rosa, CA 95405

Phone

(707) 526-7920

Fax

(707) 526-0459

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Nena Knight

Title

Office Manager

Phone

(707) 526-7920

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jeffery Broffman MD Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffery Broffman, M.D.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Santa Rosa, CA
  • NPI 1659543247
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1346315181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 SONOMA AVE",
            "address_2": "#101",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-526-7920",
            "fax_number": "707-526-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 SONOMA AVE",
            "address_2": "#101",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-526-7920",
            "fax_number": "707-526-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JEFF BROFFMAN A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "NENA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "707-526-7920"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G53420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G534200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffery Broffman MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dr. Jerry Dampier, Licensed Psychologist

• Otolaryngology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.