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

Dr. Derald E Brackmann, MD

Individual provider Otology & Neurotology Physician · NPI 1508876699

Dr. Derald E Brackmann, MD is an Otolaryngology in Los Angeles, California. Graduated from University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb) in 1962, 64 years ago. Practices with PIH Health Physicians, a 614-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
64
Trained at
University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb)
Licensed in
CA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2100 W 3rd St Ste 111
Los Angeles, CA 90057-1999
Phone: (213) 483-9930
Fax: (213) 483-0905
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Otology & Neurotology Physician (primary) Taxonomy 207YX0901X · Licence G11124 (CA)

Record details

NPI number1508876699
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 9, 2006
Last updated in NPPESSeptember 3, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOTOLARYNGOLOGY
Also practisesNEUROLOGY
Medical schoolUNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated 1962 (64 years in practice)
Group practice Pih Health Physicians — 614 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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