MEDICARE: THOMAS BROOKSHIRE P.A.

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	363A00000X	Physician Assistant	12042	CA

General Provider Information

NPI Number	:	1720282684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS BROOKSHIRE P.A.

Provider Business Mailing Address
First Line	:	279 MILLER AVE
Second Line	:
City	:	MILL VALLEY
State	:	CA
Zip	:	94941-2832
Country	:	US
Telephone Number	:	415-388-2801
Fax Number	:	415-388-2803

Provider Business Practice Location Address
First Line	:	279 MILLER AVE
Second Line	:
City	:	MILL VALLEY
State	:	CA
Zip	:	94941-2832
Country	:	US
Telephone Number	:	415-388-2801
Fax Number	:	415-388-2803

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

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	09/13/2024

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Directions to “ THOMAS BROOKSHIRE P.A.” Practice Location

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