Dr Kelly E Brodetsky, PHARMD is a
Pharmacist based in Mendocino, California. Dr Kelly E Brodetsky is licensed to practice in California (license number PHY45989) and her current practice location is
10501 Lansing Street, #904, Mendocino, California. She can be reached at her office (for appointments etc.) via phone at
(707) 937-4800.
NPI number for Dr Kelly E Brodetsky is 1659446540 and her current mailing address is Po Box 904, Mendocino, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1659446540.
Healthcare Provider's Profile
| Full Name | Dr Kelly E Brodetsky |
|---|
| Gender | Female |
|---|
| Speciality | Pharmacist |
|---|
| Location | 10501 Lansing Street, Mendocino, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1659446540
- Provider Enumeration Date: 11/24/2006
- Last Update Date: 03/07/2023
Medical Identifiers
Medical identifiers for Dr Kelly E Brodetsky such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659446540 | NPI | - | NPPES |
| PHY45989 | Other | CA | STATE LICENSE NUMBER |
| 412046786 | Other | CA | FEDERAL TAX ID |
| 0582292 | Other | CA | NCPDP NUMBER |
| PHA459890 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 183500000X | Pharmacist | PHY45989 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kelly E Brodetsky is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kelly E Brodetsky, PHARMD
Po Box 904,
Mendocino, CA 95460-0904
Ph: (707) 937-4800 | Dr Kelly E Brodetsky, PHARMD
10501 Lansing Street, #904,
Mendocino, CA 95460-0904
Ph: (707) 937-4800 |
Reviews and Comments