Individual
BROOK GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1555 SOQUEL DR, SANTA CRUZ, CA 95065-1705
(831) 462-7700
Mailing address
415 14TH AVE, SANTA CRUZ, CA 95062-4821
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A160800
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2016
Last updated
07/01/2019
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