Healthcare Provider Details

I. General information

NPI: 1649706441
Provider Name (Legal Business Name): BROOKE DANYELLE CUI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BROOKE DANYELLE SCHEIDEMANTLE MD

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S
ORANGE CA
92868-3201
US

IV. Provider business mailing address

101 THE CITY DR S
ORANGE CA
92868-3201
US

V. Phone/Fax

Practice location:
  • Phone: 800-465-3203
  • Fax:
Mailing address:
  • Phone: 800-465-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number036.151602
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125.070235
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: