TODD G. BROBERG MD
NPI 1174682777
Otolaryngology - Plastic Surgery within the Head & Neck in San Diego, CA

Q: What is Todd Broberg's NPI number?

The NPI number for Todd Broberg is 1174682777. It was assigned to this individual provider in the NPPES registry on December 8, 2006.

Q: What is Todd Broberg's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Plastic Surgery within the Head & Neck, with taxonomy code 207YX0007X.

Q: When was this NPI record last updated?

The NPPES record for Todd Broberg was last updated on November 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 08, 2006PECOS EnrolledAccepts Medicare Assignment

4647 ZION AVE, SAN DIEGO, CA 92120(619) 528-5000 Get Directions Write a Review

NPPES record last updated: November 30, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Todd G. Broberg Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TODD G. BROBERG MD (NPI 1174682777) is an individual plastic surgery within the head & neck provider in San Diego, California, licensed in California (G79418) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, San Francisco School Of Medicine (1993).

NPPES Registry Identity

NPI1174682777

Entity TypeIndividualMale

Primary Taxonomy207YX0007X

Provider Legal NameTODD G. BROBERGCredential: MD

Location Address4647 ZION AVESan Diego, CA 92120-2507

Mailing Address4647 Zion AveSan Diego, CA 92120-2507 · (619) 528-5000

Phone(619) 528-5000

Sole ProprietorNo

Medical School CMSUniversity Of California, San Francisco School Of MedicineGraduated 1993

Enumeration DateDecember 8, 2006

Last NPPES UpdateNovember 30, 2021

✔ NPI 1174682777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Plastic Surgery within the Head & NeckAllopathic & Osteopathic Physicians

Taxonomy Code207YX0007X

License✔ Licensed in CA · G79418

Definition

An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.

4647 ZION AVE, San Diego, CA 92120

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Todd G. Broberg Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4688862212

PECOS Enrollment IDI20101227000600

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANN MARIE PENA MD

Obstetrics & Gynecology

4647 ZION AVE
SAN DIEGO, CA 92120

San Diego County (619) 528-5000

DR. SHWETA WARNER M.D.

Internal Medicine (Infectious Disease)

4647 ZION AVE
SAN DIEGO, CA 92120

San Diego County (619) 221-6258

DR. MATTHEW JAMES ROOSEVELT M.D.

Internal Medicine

4647 ZION AVE, DEPARTMENT OF HOSPITAL MEDICINE
SAN DIEGO, CA 92120

San Diego County (619) 952-5091

RICHARD FUNG

Pharmacist

4647 ZION AVE
SAN DIEGO, CA 92120

San Diego County (626) 278-2749

ARDIS L TASCHNER CRNA

Nurse Anesthetist, Certified Registered

4647 ZION AVE
SAN DIEGO, CA 92120

San Diego County (619) 528-5000

JEANNE HAGER DONAHUE LCSW

Social Worker (Clinical)

4647 ZION AVE
SAN DIEGO, CA 92120

San Diego County (619) 528-5323

DAVID M. LEVINE MD

Internal Medicine (Pulmonary Disease)

4647 ZION AVE
SAN DIEGO, CA 92120

San Diego County (619) 528-5000

DALE K. LIEU MD

Internal Medicine (Infectious Disease)

4647 ZION AVE
SAN DIEGO, CA 92120

San Diego County (619) 528-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Todd Broberg's NPI number?

The NPI number for Todd Broberg is 1174682777. It was assigned to this individual provider in the NPPES registry on December 8, 2006.

Where is Todd Broberg located?

Todd Broberg practices at 4647 Zion Ave, San Diego, CA 92120. The listed phone number is (619) 528-5000.

What is Todd Broberg's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Plastic Surgery within the Head & Neck, with taxonomy code 207YX0007X.

Is Todd Broberg enrolled in Medicare?

Yes. Todd Broberg is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Todd Broberg was last updated on November 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.