DR. GEORGE BRODER (NPI# 1447234315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447234315 |
| Entity Type | Individual |
| Full Name | DR. GEORGE BRODER |
| Credential | M.D. |
| Practice Address |
11386 Pleasant Valley Rd Penn Valley CA 95946-9000 |
| Practice Telephone | 5302059850 |
| Practice Fax Number | 5302059854 |
| Mailing Telephone | 5302059850 |
| Mailing Fax Number | 5302059854 |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2019-01-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
G9678 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1447234315 | 05 | |
| CA | FEDERAL CLIA # | 05D2039302 | 01 |
| CA | BLUE SHIELD PIN # | 000G96780 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760488597 | George Broder | Radiology | 865 W Lancaster Ave, Bryn Mawr, PA 19010-3336 | 2005-06-27 |
| Street Address |
11386 PLEASANT VALLEY RD |
| City | PENN VALLEY |
| State | CA |
| Zip Code | 95946-9000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841218724 | Ian Macarthur Gow | Physician Assistant | 11386 Pleasant Valley Rd, Penn Valley, CA 95946 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053583351 | Janet Ruth Bacheler | Psychologist | 11246 Pleasant Valley Road, Penn Valley, CA 95946 | 2008-03-26 |
| 1346386257 | Penn Valley Fire Protection District | Ambulance | 10513 Spenceville Road, Penn Valley, CA 95946 | 2007-01-29 |
| 1821154188 | Karen M Rinkleib | Chiropractor | 17328 Penn Valley Dr., Ste. C, Penn Valley, CA 95946 | 2006-12-29 |
| 1770673493 | Elizabeth Wobus | Internal Medicine | 11244 Pleasant Valley Dr, Penn Valley, CA 95946 | 2006-10-13 |
| 1013964220 | Wildwood Medical, A Medical Corp. | Family Medicine | 11244 Pleasant Valley Rd, Penn Valley, CA 95946 | 2006-05-31 |
| 1467654145 | Donald Wayne Magnuson | Dentist | 17420 Penn Valley Dr, Penn Valley, CA 95946-8945 | 2007-06-04 |
| 1851341812 | Patricia Hastert | Chiropractor | 17593 Penn Valley Dr, Penn Valley, CA 95946-8956 | 2006-05-11 |
| 1013981851 | Dva Renal Healthcare Inc | Clinic/Center | 11374 Pleasant Valley Rd, Penn Valley, CA 95946-9000 | 2006-02-16 |
| 1770535585 | Mara Berezniak | Family Medicine | 11400 Pleasant Valley Rd, Penn Valley, CA 95946-9001 | 2006-05-17 |
| 1952300782 | Wildwood Physical Therapy Inc | Clinic/Center | 11392 Pleasant Valley Rd, Penn Valley, CA 95946-9001 | 2005-07-14 |
| Find all providers in zip 95946 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194031344 | Harold Jerome Robinson | Internal Medicine | 409 Old Gulph Road, Penn Valley, PA 19072-1442 | 2010-08-26 |
| 1669561775 | Edward Samuel Singer | Internal Medicine | 1650 Oakwood Drive, E216, Penn Valley, PA 19072 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1336754472 | Ankur Gupta Medical Corporation | Internal Medicine | 820 S Akers St Ste 130, Visalia, CA 93277-8346 | 2020-09-15 |
| 1295351740 | Penciu Medical Apmc | Internal Medicine | 1585 Sierra Madre Villa Ave, Pasadena, CA 91107-1259 | 2020-06-21 |
| 1679113336 | La Pulse Medical, Inc | Internal Medicine | 14558 Sylvan St Ste 105, Van Nuys, CA 91411-2324 | 2020-01-10 |
| 1770122871 | John R. Nelson M.d. Inc. | Internal Medicine | 7061 N Whitney Ave Ste 101, Fresno, CA 93720-8025 | 2020-01-06 |
| 1730725789 | Norcal Medical Services, Inc | Internal Medicine | 2267 Lava Ridge Ct, Roseville, CA 95661-3062 | 2019-11-25 |
| 1932750957 | Enloe Medical Center | Internal Medicine | 1430 Esplanade Ste 6, Chico, CA 95926-3366 | 2019-09-20 |
| 1528610425 | Nicholas Russell | Internal Medicine | 2967 N Moorpark Rd, Thousand Oaks, CA 91360-4573 | 2019-07-10 |
| 1043871627 | Gy Medical Clinic Inc | Internal Medicine | 7400 Van Nuys Blvd Ste 112, Van Nuys, CA 91405-1972 | 2019-06-25 |
| 1902465792 | Pacific Heart & Vascular | Internal Medicine | 1234 W. Chapman Ave, Ste #101, Orange, CA 92868-2862 | 2019-06-06 |
| Find all providers with the same taxonomy | ||||
| City | PENN VALLEY |
| Zip Code | 95946 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.