MEDICARE: DR. ANDREA S BROOKE 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	174400000X	Specialist	G 65428	CA

General Provider Information

NPI Number	:	1285922526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA S BROOKE MD

Provider Business Mailing Address
First Line	:	29625 STRAWBERRY HILL DR
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-4012
Country	:	US
Telephone Number	:	818-706-1064
Fax Number	:	818-706-1064

Provider Business Practice Location Address
First Line	:	29625 STRAWBERRY HILL DR
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-4012
Country	:	US
Telephone Number	:	818-706-1064
Fax Number	:	818-706-1064

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

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	07/20/2011

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