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General NPI Number Information
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NPI Number | 1922019819
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Entity Type | Individual
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Provider Name | PHILIP G BROOKS MD
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Gender | Male
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 8631 W 3RD ST SUITE 510E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5901
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Country | US
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Telephone | 310-278-1490
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Fax | 310-659-3049
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Provider Business Mailing Address
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Address Line | 8631 W 3RD ST SUITE 510E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5901
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Country | US
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Telephone | 310-278-1490
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Fax | 310-659-3049
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | A19096
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | A19096
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License Number State | CA
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