# BROOKE GIFFORD, DPM INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023361862
- **Authorized official:** DR. BROOKE GIFFORD DPM (DOCTOR)
- **Authorized official phone:** (805) 444-8424

## Contact information

- **Practice address:** 425 HAALAND DR, 201, THOUSAND OAKS, CA 91361-5229
- **Practice address phone:** (805) 496-2383
- **Mailing address:** 710 TENNIS CLUB LN, CA, THOUSAND OAKS, CA 91360-4213
- **Mailing address phone:** (805) 444-8424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | E4889 | CA | Yes |

## Other

- **Enumeration date:** 10/17/2012
- **Last updated:** 10/17/2012