| Organization Name: | THE MEDICAL OFFICES OF KENNETH R BROOKS, PROFESSIONAL CORPORATION |
| NPI Number: | 1427308121 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENNETH R BROOKS (PRESIDENT) |
| Mailing Address: | 3431 Broadway St Suite A-8 American Canyon |
| State: | CA US |
| Postal Code: | 945031228 |
| Phone Number: | 7076457229 |
| Fax Number: | 7077457431 |
| NPI Enumeration Date: | 09/11/2012 |
| NPI Last Update Date: | 09/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |