Brouha Dermatology, P.C.

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

A97902 Issued in CA

Legal business name

BROUHA DERMATOLOGY, P.C.

Practice address

1319 Beryl St
San Diego, CA 92109-2102

Phone

(858) 281-5181

NPI assigned

Jan 28, 2016

Organization subpart

No

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

Authorized official

Name

Alana Erickson

Title

Director

Phone

(208) 315-4141

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1487011995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 BERYL ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921092102",
            "telephone_number": "858-281-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 BERYL ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921092102",
            "telephone_number": "858-281-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROUHA DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-28",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "ALANA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "208-315-4141"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A97902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Cecil Brothers, CPS
• Tom J Brotherton, PHARMD
• Steven C. Brotman, MD
• Corrie D Broudy, MD
• Caiden Nathanial Broughton
• Sharon Brouha, M.D
• Richard Brouillette, LCSW
• Ashley Elizabeth Broussard, FNP
• Kennedi Broussard
• Lisette Broussard, BCBA

• All providers in San Diego, CA
• Dermatopathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.