DR. FREDERICK EVAN BROUSSARD RPH - NPI 1194311217

Q: What is Frederick Broussard's NPI number?

The NPI number for Frederick Broussard is 1194311217. It was assigned to this individual provider in the NPPES registry on December 13, 2020.

Q: What is Frederick Broussard's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

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About Dr. Frederick Evan Broussard Rph NPPES

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

DR. FREDERICK EVAN BROUSSARD RPH (NPI 1194311217) is an individual pharmacist in La Jolla, California, licensed in California (83939) and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1194311217

Entity TypeIndividualMale

Primary Taxonomy183500000X

Provider Legal NameDR. FREDERICK EVAN BROUSSARDCredential: RPH

Location Address8831 VILLA LA JOLLA DRLa Jolla, CA 92037-1949

Mailing Address8831 Villa La Jolla DrLa Jolla, CA 92037-1949 · (858) 457-4480

Phone(858) 457-4480

Sole ProprietorNo

Enumeration DateDecember 13, 2020

NPPES CertifiedDecember 11, 2020

✔ NPI 1194311217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers

Taxonomy Code183500000X

License✔ Licensed in CA · 83939

Definition

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

8831 VILLA LA JOLLA DR, La Jolla, CA 92037

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Other Identifiers 1

Other83938CA · 83938

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.

FELIX LOPEZ RSLD

Technician/Technologist (Optician)