Individual provider · NPI-1

Adam Corey Broedel

Respiratory Therapist, Certified · Los Angeles, CA

NPI number1528787116
StatusActive
Last updated in NPPESAug 25, 2022

Details

NPI
1528787116
Entity type
Individual (NPI-1)
Name
Adam Corey Broedel
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 25, 2022
Certification date
Aug 25, 2022
Last updated
Aug 25, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
227800000X Respiratory Therapist, Certified30565CAYes

Practice location

2051 Marengo St
Los Angeles, CA 90033-1352

Phone 323-409-7928

Mailing address

2051 Marengo St
Los Angeles, CA 90033-1352

Phone 323-409-7928

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