Provider Demographics
NPI:1366645582
Name:BRAFF, DAVID LEON (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEON
Last Name:BRAFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W ARBOR DRIVE
Mailing Address - Street 2:MAIL CODE 8816
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-8816
Mailing Address - Country:US
Mailing Address - Phone:619-543-5570
Mailing Address - Fax:619-543-2493
Practice Address - Street 1:200 W ARBOR DRIVE
Practice Address - Street 2:MAIL CODE 8816
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8816
Practice Address - Country:US
Practice Address - Phone:619-543-5570
Practice Address - Fax:619-543-2493
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG22701282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital