Provider Demographics
NPI:1255416335
Name:BROSMAN, STANLEY ALLEN (MD)
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:ALLEN
Last Name:BROSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1278 S CAMDEN DR
Mailing Address - Street 2:#302
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035
Mailing Address - Country:US
Mailing Address - Phone:310-828-8531
Mailing Address - Fax:310-829-1350
Practice Address - Street 1:2021 SANTA MONICA BLVD
Practice Address - Street 2:#510
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-828-8531
Practice Address - Fax:310-829-1350
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC22619208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology