Doctor Name: | DR. DAVID REESE HOLBROOKE |
NPI Number: | 1265720411 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | G18811 |
Business Practice Address: | 120 Bulkley Ave #405 Sausalito, CA - 949653200 |
Business Phone Number: | 4153313883 |
Business Fax Number: | 4153318778 |
Mailing Address: | 685 Spring St, #112 FRIDAY HARBOR |
State: | WA |
Postal Code: | 982508058 |
Phone Number: | 4153313883 |
Fax Number: | 4153318778 |
NPI Enumeration Date: | 07/20/2011 |
NPI Last Update Date: | 07/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G18811 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |