Dr David Guannan Li, MD, MBA | |
680 Centre St, Brockton, MA 02302-3308 | |
(909) 762-8372 | |
Not Available |
Full Name | Dr David Guannan Li |
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Gender | Male |
Speciality | General Practice |
Location | 680 Centre St, Brockton, Massachusetts |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1891355186 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | 1770504599 (Massachusetts) | Primary |
Entity Name | Boston Dermatology And Laser Center Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215963574 PECOS PAC ID: 0941271407 Enrollment ID: O20040805001451 |
Mailing Address | Practice Location Address |
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Dr David Guannan Li, MD, MBA 32 Queensberry St Apt 12a, Boston, MA 02215-5260 Ph: (909) 762-8372 | Dr David Guannan Li, MD, MBA 680 Centre St, Brockton, MA 02302-3308 Ph: (909) 762-8372 |
John W Thompson Jr., MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 235 N Pearl St, Brockton, MA 02301 Phone: 508-427-3741 Fax: 508-427-3991 | |
Jason Lou, General Practice Medicare: Medicare Enrolled Practice Location: 110 Liberty St, Brockton, MA 02301 Phone: 508-565-3055 | |
Warren Russell Nickerson, MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 1 Pearl St, Brockton, MA 02301 Phone: 508-584-4107 |