NPI 1609300649 · live from the CMS NPI Registry
Merrick Adam Brodsky, MD
Dermatology, MOHS-Micrographic Surgery in Long Beach, CA. National Provider Identifier 1609300649, active.
NPI record
| NPI | 1609300649 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology, MOHS-Micrographic Surgery 207ND0101X |
| Practice location | 3828 Schaufele Ave Ste 300, Long Beach, CA 90808 |
| Practice phone | 562-997-1144 |
| Mailing address | 12700 Park Central Dr Ste 1210, Dallas, TX 75251 |
| Enumerated | April 17, 2017 |
| Last updated | April 7, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Dermatology, MOHS-Micrographic Surgery primary | 207ND0101X | A178273 (CA) |
| Dermatology | 207N00000X | 61263332 (WA) |
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | 61263332 (WA) |
| Dermatology, Procedural Dermatology | 207NS0135X | 61263332 (WA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.