Organization
WILLIAM K BROKKEN
Active
Organization
WILLIAM K BROKKEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM K BROKKEN MD (OWNER)
(805) 682-6455
Entity
Organization
Contact information
Practice address
504 W PUEBLO ST, STE 202, SANTA BARBARA, CA 93105-6211
(805) 682-6455
(805) 687-1482
Mailing address
504 W PUEBLO ST, STE 202, SANTA BARBARA, CA 93105-6211
(805) 682-6455
(805) 687-1482
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
C33750
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0584671
CLIA
CA
Enumeration date
08/02/2005
Last updated
06/24/2008
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