Linda Carol Broussard, P.A.-C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11346 Issued in CA

Practice address

1701 E Florida Ave
Hemet, CA 92544-4632

Phone

(951) 658-4486

Fax

(951) 925-1026

NPI assigned

Aug 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Somagen Healthcare Inc

  • Urgent Care Clinic/Center
  • San Diego, CA
  • NPI 1558788620
  NPD
• Somagen Healthcare Inc

  • Urgent Care Clinic/Center
  • Santee, CA
  • NPI 1396058137
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365120000000",
    "number": "1679584445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 E STETSON AVE # 116",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925437139",
            "telephone_number": "951-230-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E FLORIDA AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925444632",
            "telephone_number": "951-658-4486",
            "fax_number": "951-925-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "LINDA",
        "middle_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "P.A.-C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2013-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA11346",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA11346",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridging Lives LLC
• Evelyn Bright, FNP
• Igor Mark Bron, MD
• Brookview Medical Corporation
• Margaret Brophy
• Thelma Brown-Thompson
• Catherine Susie Brown, NP-C
• Heather Brown
• Kevin Michael Brown, DC
• Michelle M Brown, PT

• Physician Assistant in Hemet, CA
• Providers in Hemet, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.