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NPI Code Detail

MEDICARE: BROOKE BURNS D.O.

MEDICARE: BROOKE BURNS D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician0102205327VA

General Provider Information

NPI Number : 1245644095
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE BURNS D.O.
Provider Business Mailing Address
First Line : 2442 VINE ST
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-3672
Country : US
Telephone Number : 760-791-0490
Fax Number :
Provider Business Practice Location Address
First Line : 1699 N IMPERIAL AVE
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-1320
Country : US
Telephone Number : 760-352-2551
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2014
Last Update Date : 02/05/2025

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Directions to “ BROOKE BURNS D.O.” Practice Location

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