DR. LORI BRODERICK M.D., PH.D.
NPI 1417152232
Allergy & Immunology in San Diego, CA

Q: What is Lori Broderick's NPI number?

The NPI number for Lori Broderick is 1417152232. It was assigned to this individual provider in the NPPES registry on June 20, 2007.

Q: What is Lori Broderick's specialty?

The primary specialty registered for this NPI is Allergy & Immunology with taxonomy code 207K00000X.

Q: When was this NPI record last updated?

The NPPES record for Lori Broderick was last updated on March 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 June 20, 2007PECOS Enrolled

8110 BIRMINGHAM WAY, SAN DIEGO, CA 92123(858) 966-5961 Get Directions Write a Review

NPPES record last updated: March 14, 2016. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Dr. Lori Broderick M.d., Ph.d. NPPES

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

DR. LORI BRODERICK M.D., PH.D. (NPI 1417152232) is an individual allergy & immunology provider in San Diego, California, licensed in California (A106397) and active in the NPI registry since June 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417152232

Entity TypeIndividualFemale

Primary Taxonomy207K00000X

Provider Legal NameDR. LORI BRODERICKCredential: M.D., PH.D.

Location Address8110 BIRMINGHAM WAYSan Diego, CA 92123-2758

Mailing Address3020 Childrens Way, Mc5003San Diego, CA 92123-4223 · (858) 309-6300

Phone(858) 966-5961

Sole ProprietorNo

Enumeration DateJune 20, 2007

Last NPPES UpdateMarch 14, 2016

✔ NPI 1417152232 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAllergy & ImmunologyAllopathic & Osteopathic Physicians

Taxonomy Code207K00000X

License✔ Licensed in CA · A106397

Definition

An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system.

Also ListedPediatricsTaxonomy 208000000X · License A106397 (CA)

8110 BIRMINGHAM WAY, San Diego, CA 92123

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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 (PECOS)

Dr. Lori Broderick M.d., Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

MRS. SARA OJEDA LOPEZ CPNP

Nurse Practitioner (Pediatrics)

8110 BIRMINGHAM WAY, BLDG 28
SAN DIEGO, CA 92123

San Diego County (858) 966-5961

ROBERT MILLER SHEETS M.D.

Pediatrics (Pediatric Rheumatology)

8110 BIRMINGHAM WAY
SAN DIEGO, CA 92123

San Diego County (858) 966-8082

JEANNIE SHIH HUANG M.D.

Pediatrics (Pediatric Gastroenterology)

8110 BIRMINGHAM WAY
SAN DIEGO, CA 92123

San Diego County (858) 966-4003

JOEL EDWARD LAVINE M.D., PH.D.

Pediatrics (Pediatric Gastroenterology)

8110 BIRMINGHAM WAY
SAN DIEGO, CA 92123

San Diego County (858) 966-4003

MICHAEL EVERETT GOTTSCHALK M.D., PH.D.

Pediatrics (Pediatric Endocrinology)

8110 BIRMINGHAM WAY
SAN DIEGO, CA 92123

San Diego County (858) 966-4032

MAJA MARINKOVIC M.D.

Pediatrics (Pediatric Endocrinology)

8110 BIRMINGHAM WAY, BUILDING 28
SAN DIEGO, CA 92123

San Diego County (858) 966-4032

MEERANA LIM M.D.

Pediatrics (Pediatric Pulmonology)

8110 BIRMINGHAM WAY
SAN DIEGO, CA 92123

San Diego County (858) 966-5846

DANA PATTON-KU M.D.

Pediatrics (Pediatric Gastroenterology)

8110 BIRMINGHAM WAY
SAN DIEGO, CA 92123

San Diego County (858) 966-4003

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 Lori Broderick's NPI number?

The NPI number for Lori Broderick is 1417152232. It was assigned to this individual provider in the NPPES registry on June 20, 2007.

Where is Lori Broderick located?

Lori Broderick practices at 8110 Birmingham Way, San Diego, CA 92123. The listed phone number is (858) 966-5961.

What is Lori Broderick's specialty?

The primary specialty registered for this NPI is Allergy & Immunology with taxonomy code 207K00000X.

Is Lori Broderick enrolled in Medicare?

Yes. Lori Broderick is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Lori Broderick was last updated on March 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.