MEDICARE: DAVID BROOKS MD

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
1	207Q00000X	Family Medicine Physician	G11503	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568642221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BROOKS MD

Provider Business Mailing Address
First Line	:	176 S PALM DR
Second Line	:
City	:	BLYTHE
State	:	CA
Zip	:	92225-2536
Country	:	US
Telephone Number	:	760-922-1020
Fax Number	:	760-922-1050

Provider Business Practice Location Address
First Line	:	176 S PALM DR
Second Line	:
City	:	BLYTHE
State	:	CA
Zip	:	92225-2536
Country	:	US
Telephone Number	:	760-922-1020
Fax Number	:	760-922-1050

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2007
Last Update Date	:	01/02/2009

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Directions to “ DAVID BROOKS MD” Practice Location

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