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1285645002
PETER BRODERICK
MODESTO, CA
NPI
1285645002
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: CA G63629)
Enumeration Date
2006-08-10
Last Update Date
2015-07-22
Business Address
Dr. PETER BRODERICK M.D., M.Ed.
401 PARADISE RD SUITE E
MODESTO, CA 95351-3104
Phone number: 209-558-4000
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Mailing Address
Dr. PETER BRODERICK M.D., M.Ed.
10470 OLD PLACERVILLE RD SUITE 100
SACRAMENTO, CA 95827-2539
Phone number: 800-470-0071
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