Broderick-Villa, Gregory

Broderick-Villa, Gregory is an individual health care provider with primary practice located at 365 Hawthorne Ave 101, Oakland CA 94609-3107. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Broderick-Villa, Gregory can be contacted via phone (510) 465-5523.

Contact Information

Primary practice address
365 Hawthorne Ave 101 Oakland CA 94609-3107
Phone: (510) 465-5523
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X A82944 California

Profile Details

NPI number 1376571562
LBN Legal business name Broderick-Villa, Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2006
Last updated Dec 27th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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