Provider Demographics
NPI:1558601872
Name:BRODSKY, STUART ALLEN (DO)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:ALLEN
Last Name:BRODSKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:STUART
Other - Middle Name:ALLEN
Other - Last Name:BRODSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:2803 TORRY CT
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-7116
Mailing Address - Country:US
Mailing Address - Phone:760-603-0806
Mailing Address - Fax:
Practice Address - Street 1:2803 TORRY CT
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-7116
Practice Address - Country:US
Practice Address - Phone:760-603-0806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A3659208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery