BRODERICH ALEXANDER DURLEY (NPI# 1609415116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609415116 |
| Entity Type | Individual |
| Full Name | BRODERICH ALEXANDER DURLEY |
| Practice Address |
14235 Oakley Dr Riverside CA 92503-7236 |
| Practice Telephone | 9512313916 |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2019-12-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
14235 OAKLEY DR |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92503-7236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255953618 | Mohammad Abul-fielat Dds Inc | Dentist | 3825 Tyler St, Riverside, CA 92503 | 2020-05-08 |
| 1205396488 | Francisco Aguayo | Behavioral Analyst | 3345 Jackson St, Riverside, CA 92503 | 2019-03-22 |
| 1073071684 | Racheal Ego Aneke | Nurse Practitioner | 9890 County Farm Rd., Building 2, Riverside, CA 92503 | 2019-03-04 |
| 1073070264 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 3500 Tyler Mall, Riverside, CA 92503 | 2019-02-25 |
| 1053893271 | Tsibel Dental Practice Inc. | Dentist | 10181 Magnolia Ave, Riverside, CA 92503 | 2018-09-04 |
| 1508344714 | Patricia Marraine Redondo | Counselor | 1625 14th St, Riverside, CA 92503 | 2018-07-31 |
| 1740766146 | Robles Rodef & Yaghoubi Dental Corporation | Dentist | 5628 Van Buren Blvd Suite #a, Riverside, CA 92503 | 2018-07-18 |
| 1467961755 | Daniela Popa | Assisted Living Facility | 10820 Calle Bella, Riverside, CA 92503 | 2017-09-29 |
| 1457860306 | Leah Dreany | Peer Specialist | 2085 Rustin Avenue Building #3, Riverside, CA 92503 | 2017-09-22 |
| 1710400445 | Christopher John Guting | Peer Specialist | 10230 Indiana Avenue, Riverside, CA 92503 | 2017-07-25 |
| Find all providers in zip 92503 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447870365 | Monica Sameh Hanna | Student in an Organized Health Care Education/Training Program | University of California Riverside School of Medicine, 14350 Meridian Pkwy # 2, Riverside, CA 92518-3035 | 2020-04-21 |
| 1861011876 | Monika Ellyn Garcia | Student in an Organized Health Care Education/Training Program | 14350 Meridian Parkway Box #2, Riverside, CA 92518 | 2020-04-09 |
| 1568099976 | Victoria Lee | Student in an Organized Health Care Education/Training Program | Riverside Family Medicine Residency, 10800 Magnolia Avenue, Riverside, CA 92505 | 2020-03-25 |
| 1114553765 | Pamela Picchi | Student in an Organized Health Care Education/Training Program | 111 Prescott Ave, Riverside, RI 02915-1944 | 2020-03-16 |
| 1538794094 | Jason Washington | Student in an Organized Health Care Education/Training Program | 4301 La Sierra Ave Apt 50, Riverside, CA 92505-2906 | 2020-03-05 |
| 1144860404 | Brian Jisu Shin | Student in an Organized Health Care Education/Training Program | 8293 Perla Dr, Riverside, CA 92504-2419 | 2020-01-14 |
| 1861031353 | Alex Tovar | Student in an Organized Health Care Education/Training Program | 16901 Clementine Ct, Riverside, CA 92503-6935 | 2019-12-31 |
| 1477192979 | Gregory David White | Student in an Organized Health Care Education/Training Program | 7965 Los Arboles Pl, Riverside, CA 92504-3530 | 2019-12-31 |
| 1407497076 | Guadalupe Rocha | Student in an Organized Health Care Education/Training Program | 10135 Hillsborough Ln, Riverside, CA 92503-1018 | 2019-10-03 |
| 1326691494 | John Michael Stewart | Student in an Organized Health Care Education/Training Program | 4716 Cliffside Dr, Riverside, CA 92506-1076 | 2019-07-18 |
| Find all providers in RIVERSIDE | ||||
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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.