Provider Demographics
NPI:1649227885
Name:BRODDRICK, FRANCES ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCES
Middle Name:ANNE
Last Name:BRODDRICK
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2350 E BIDWELL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3455
Mailing Address - Country:US
Mailing Address - Phone:916-920-6337
Mailing Address - Fax:916-673-5916
Practice Address - Street 1:4156 MANZANITA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-1726
Practice Address - Country:US
Practice Address - Phone:916-483-5400
Practice Address - Fax:916-483-1937
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG67019207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE95173Medicare UPIN