Individual
DR. BROOK L BROUHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD/PHD
Contact information
Practice address
7300 GIRARD AVE, SUITE 104, LA JOLLA, CA 92037-5138
(858) 750-2983
(858) 750-2984
Mailing address
2285 CORPORATE CIR, STE 200, HENDERSON, NV 89074-7759
(702) 360-2763
(949) 783-2880
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
A97902
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DL390Z
MEDICARE PTAN
CA
Enumeration date
08/12/2008
Last updated
04/06/2017
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