ROBERT BROUILLARD (NPI# 1487626420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487626420 |
| Entity Type | Individual |
| Full Name | ROBERT BROUILLARD |
| Practice Address |
9850 Genesee Ave Ste 830 La Jolla CA 92037-1224 |
| Practice Telephone | 8585521410 |
| Mailing Telephone | 8585521410 |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
G34053 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DEA REGISTRATION NUMBER | AB7662821 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154508703 | Robert E Brouillard | Specialist | 5440 W Franklin Rd, Ste 100, Boise, ID 83705-1079 | 2008-01-25 |
| Street Address |
9850 GENESEE AVE STE 830 |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92037-1224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598760589 | Frank Edward Mayer | Internal Medicine | 9850 Genesee Ave, Ste 930, La Jolla, CA 92037-1229 | 2005-06-16 |
| 1649717737 | La Jolla Anesthesia Associates Lp | Nurse Anesthetist, Certified Registered | 9850 Genesee Ave, Suite 980, La Jolla, CA 92037-1224 | 2017-01-26 |
| 1083151674 | Stephanie Klein | Physician Assistant | 9850 Genesee Ave, Ste 320, La Jolla, CA 92037-1208 | 2017-01-20 |
| 1346785250 | Lee Marie Atwood | Nurse Practitioner | 9850 Genesee Ave, Suite 400, La Jolla, CA 92037-1224 | 2017-01-01 |
| 1447795661 | Kirsten Goshen | Nurse Practitioner | 9850 Genesee Ave, Suite 570, La Jolla, CA 92037-1224 | 2016-12-24 |
| 1194279901 | Ellen Ashman | Nurse Practitioner | 9850 Genesee Ave, La Jolla, CA 92037-1224 | 2016-08-09 |
| 1164875175 | Miranda Mulholland | Nurse Practitioner | 9850 Genesee Ave, Suite 560, La Jolla, CA 92037-1224 | 2016-07-14 |
| 1578938023 | Schoemann Medical Corporation | Surgery | 9850 Genesee Ave, Suite 500, La Jolla, CA 92037-1224 | 2015-12-09 |
| 1679946040 | Lauren E Campagna | Physician Assistant | 9850 Genesee Ave, Suite 320, La Jolla, CA 92037-1224 | 2015-11-07 |
| 1750751269 | Charles Mears | Specialist/Technologist, Other | 9850 Genesee Ave, Suite210, La Jolla, CA 92037-1224 | 2015-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982221768 | Equip Health Medical, PC | Clinic/Center | 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 | 2020-06-29 |
| 1134745474 | Brenda Kay Wiederhold | Psychologist | Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 | 2020-06-23 |
| 1316581598 | Kathleen M Blechertas | Physical Therapist | 9888 Genesee, Lj19, La Jolla, CA 92037 | 2019-10-31 |
| 1316592876 | Kevin Yanyan Li | Student in an Organized Health Care Education/Training Program | 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 | 2019-08-01 |
| 1407400542 | Juan J Salmeron | Dentist | Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 | 2019-07-26 |
| 1609428598 | Nicole Whitney Mark | Physician Assistant | 8103 Caminito Sonoma, La Jolla, CA 92037 | 2019-07-11 |
| 1700357936 | Cecelia Rose Greene/pendzich | Mastectomy Fitter | 7760 Fay Ave, Suite M., La Jolla, CA 92037 | 2018-12-16 |
| 1740765890 | Jeenal Ankit Gordhandas | Student in an Organized Health Care Education/Training Program | East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 | 2018-09-25 |
| 1306325220 | Lisa Beth Perlov Marks | Marriage & Family Therapist | 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 | 2018-08-10 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| Find all providers in zip 92037 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467830489 | Justin Arshed Shaya | Internal Medicine | 3855 Health Sciences Dr #0829, La Jolla, CA 92093 | 2015-05-11 |
| 1679816805 | Zhubin J Gahvari | Internal Medicine | 10710 N Torrey Pines Rd # Ms 312, La Jolla, CA 92037-1035 | 2013-04-06 |
| 1760778526 | Rebecca Arielle Shatsky | Internal Medicine | 3855 Health Sciences Dr # Mc0829, Moores Cancer Center Dept of Hematology/oncology, La Jolla, CA 92093-0829 | 2011-06-21 |
| 1861784993 | Akram Mesleh Shayeb | Internal Medicine | Ucsd Health, 3855 Health Sciences Dr #0829, La Jolla, CA 92093-0829 | 2011-05-09 |
| 1831323369 | Srila Gopal | Internal Medicine | 9500 Gilman Dr # Mc0878, La Jolla, CA 92093 | 2009-05-12 |
| 1144431230 | Ayad Hamdan | Internal Medicine | 3855 Health Sciences Dr # 960, La Jolla, CA 92093-1503 | 2007-05-24 |
| 1043337173 | Imawati Budihardjo | Internal Medicine | 3855 Health Sciences Dr # 0658, La Jolla, CA 92093-0987 | 2007-03-23 |
| 1598841561 | Ewa K Carrier | Internal Medicine | 3855 Health Sciences Drive #0960, La Jolla, CA 92093-0960 | 2006-10-31 |
| 1346801289 | Compassion Breast Inc | Internal Medicine | 9888 Genesee Ave, La Jolla, CA 92037-1205 | 2019-06-21 |
| 1679935639 | Ann Marie Moeller | Internal Medicine | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2016-03-28 |
| Find all providers in LA JOLLA | ||||
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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.