Individual
DR. WILLIAM KENT BROKKEN
Active
Individual
DR. WILLIAM KENT BROKKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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
01
—
1043211907
ORGANIZATION NPI
—
Enumeration date
08/02/2005
Last updated
12/28/2023
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