William Gowing Broad, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G67157 Issued in CA

Practice address

15425 Los Gatos Blvd Ste 120
Los Gatos, CA 95032-2541

Phone

(408) 340-5700

NPI assigned

Aug 26, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927
  NPD (past)

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1750374591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15425 LOS GATOS BLVD STE 120",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322541",
            "telephone_number": "408-340-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15425 LOS GATOS BLVD STE 120",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322541",
            "telephone_number": "408-340-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "143 E Main St",
            "address_purpose": "LOCATION",
            "city": "Los Gatos",
            "state": "CA",
            "postal_code": "950306903",
            "country_code": "US",
            "telephone_number": "408-354-3920",
            "fax_number": "408-354-0782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROAD",
        "first_name": "WILLIAM",
        "middle_name": "GOWING",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G67157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR UPIN",
            "identifier": "00G671570",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anita Breckenridge, MD
• Jon Brennan, DPT
• Kelly Rose Brennan, AU.D.
• Matthew J Breske, D.C.
• Jordan Janine Britt
• Michael Brodin, M.D.
• Edward Michael Brooks, MD
• Briana Jaye Broussard
• Cindy L Brown
• Deborah Jean Brown, PA-C

• Family Medicine Physician in Los Gatos, CA
• Providers in Los Gatos, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.