| Peter H Broekelschen Md Inc | |
|
1441 Avocado Ave Suite 607 Newport Beach CA 92660 | |
| (949) 759-1042 | |
| (949) 759-0143 |
| Full Name | Peter H Broekelschen Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1441 Avocado Ave, Newport Beach, California |
| Authorized Official Name and Position | Peter H Broekelschen (PRESIDENT OWNER) |
| Authorized Official Contact | 9497591042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter H Broekelschen Md Inc 1441 Avocado Ave Suite 607 Newport Beach CA 92660 Ph: (949) 759-1042 | Peter H Broekelschen Md Inc 1441 Avocado Ave Suite 607 Newport Beach CA 92660 Ph: (949) 759-1042 |
| NPI Number | 1861501561 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 04/23/2008 |
| Medicare PECOS PAC ID | 1052492139 |
|---|---|
| Medicare Enrollment ID | O20080115000268 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861501561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | A25076 (California) | Primary |
| Provider Name | Peter Broekelschen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1366631525 PECOS PAC ID: 6507947686 Enrollment ID: I20080115000262 |
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