Basic Information
| Provider Information | |||||||||
| NPI: | 1649227885 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRODDRICK | ||||||||
| FirstName: | FRANCES | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2350 E BIDWELL ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | FOLSOM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956303455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9169206337 | ||||||||
| FaxNumber: | 9166735916 | ||||||||
| Practice Location | |||||||||
| Address1: | 4156 MANZANITA AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CARMICHAEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956081726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164835400 | ||||||||
| FaxNumber: | 9164831937 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | G67019 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.