Broome, Dale

Broome, Dale is an individual health care provider with primary practice located at 2 W Fern Ave , Redlands CA 92373-5916. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Broome, Dale can be contacted via phone (909) 793-3311.

Contact Information

Primary practice address
2 W Fern Ave Redlands CA 92373-5916
Phone: (909) 793-3311
Fax: (909) 335-1936
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G86348 California
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X G86348 California

Profile Details

NPI number 1396761631
LBN Legal business name Broome, Dale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2006
Last updated May 21st, 2019 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1396761631 NPPES
California MEDICAID 00G863480

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