Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Broad Medical Group Inc

Organization Obstetrics & Gynecology Physician · NPI 1255997763

Broad Medical Group Inc is an Obstetrics & Gynecology Physician in Costa Mesa, California. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1640 Newport Blvd Ste 300
Costa Mesa, CA 92627-7725
Phone: (949) 720-9848
Fax: (949) 720-9195
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X

Record details

NPI number1255997763
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Broad — Ceo/President · (949) 720-9848
NPI enumeratedMay 10, 2019
Last updated in NPPESSeptember 6, 2025
Certification dateSeptember 6, 2025
Mailing address1640 Newport Blvd Ste 300, Costa Mesa, CA 92627-7725

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