Tri Valley Urology

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

TRI VALLEY UROLOGY

Practice address

521 E Elder St
Suite 201
Fallbrook, CA 92028-3081

Phone

(951) 698-1901

Fax

(951) 698-1074

NPI assigned

Sep 26, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Philip P Brodak, MD

Title

Partner

Phone

(951) 698-1901

Specialties & licenses 1

Addresses

Practitioners 4

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

• Taralyn Johnson, PA-C

  • Physician Assistant
  • Laguna Hills, CA
  • NPI 1730784745
  NPD
• Andrea Pogue, PA-C

  • Physician Assistant
  • Murrieta, CA
  • NPI 1619125200
  NPD
• Nemi Mehul Shah

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Murrieta, CA
  • NPI 1558715268
  NPD
• Sreenivas N Vemulapalli, MD

  • Urology Physician
  • Murrieta, CA
  • NPI 1750359907
  NPD

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631059200000",
    "number": "1427309749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25495 MEDICAL CENTER DR",
            "address_2": "SUITE 204",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925624902",
            "telephone_number": "951-698-1901",
            "fax_number": "951-698-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E ELDER ST",
            "address_2": "SUITE 201",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283081",
            "telephone_number": "951-698-1901",
            "fax_number": "951-698-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI VALLEY UROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-26",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A",
        "authorized_official_last_name": "BRODAK",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "951-698-1901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thrifty Payless Inc (Rite Aid Pharmacy 05631)
• Tibbitts Fallbrook Dental Group
• Timothy J. Coen, M.D., P.C. (Mission Family Care)
• Brettsen Samuel Todd, PHARMD, RPH
• Christopher Andre Toupin Jr., MD
• Lacey Erin Troth, ATC
• Carrie Ufkes, LCSW
• Unity Care Medical Supplies
• Vallecitos School District
• Kim Thi Ngoc Van, RPH

• Specialist in Fallbrook, CA
• Providers in Fallbrook, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.