Individual provider · NPI-1

Benjamin I. Broder, MD

Family Medicine · Baldwin Park, CA

NPI number1902977812
StatusActive
Last updated in NPPESFeb 7, 2024

Details

NPI
1902977812
Entity type
Individual (NPI-1)
Name
Benjamin I. Broder
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Nov 13, 2006
Certification date
Feb 7, 2024
Last updated
Feb 7, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineG84784CAYes
208M00000X HospitalistG84784CA

Practice location

1011 Baldwin Park Blvd
Baldwin Park, CA 91706-5806

Phone 626-851-1011

Mailing address

2397 Highland Ave
Altadena, CA 91001-2548

Phone 323-574-8803

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Family Medicine providers in Baldwin Park, CA