Healthcare Provider Details

I. General information

NPI: 1316155781
Provider Name (Legal Business Name): REBECCA ANN BROOKS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 01/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST STE 2500
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

4860 Y ST STE 2500
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-6938
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number036.138575
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberA113741
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: