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General NPI Number Information
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NPI Number | 1174962054
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Entity Type | Individual
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Provider Name | SARAH ELIZABETH BROOME PA
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Gender | Female
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Dates
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Enumeration Date | 06/24/2013
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Last Update Date | 11/20/2015
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Provider Practice Location Address
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Address Line | 2021 MAIN ST
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City | OAKLEY
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State | CA
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Zip | 94561-3302
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Country | US
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Telephone | 925-776-8200
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Fax | 925-776-8260
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Provider Business Mailing Address
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Address Line | 4165 BLACKHAWK PLAZA CIR 100
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City | DANVILLE
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State | CA
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Zip | 94506-4691
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Country | US
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Telephone | 925-736-7070
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Fax | 925-736-7075
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA22781
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License Number State | CA
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