Individual
JENNIFER JEAN BROKAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2333 BUCHANAN ST, SAN FRANCISCO, CA 94115-1925
(209) 342-2300
(209) 524-4240
Mailing address
4301 NORTHSTAR WAY, MODESTO, CA 95356-9262
(209) 342-2300
(209) 524-4240
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G86078
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G860780
BLUE SHIELD
CA
05
—
00G860780
—
CA
Enumeration date
11/03/2005
Last updated
09/24/2014
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