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Individual
OLIVER TATE BROOKS
Active
Individual
OLIVER TATE BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G49006
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WG00613
MEDI-CAL NO.
CA
Enumeration date
09/16/2006
Last updated
03/15/2021
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