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Individual

DR. WILLIAM KENT BROKKEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4433 MEADOWLARK LN, SANTA BARBARA, CA 93105
(805) 886-8021
(805) 687-1482
Mailing address
4433 MEADOWLARK LN, SANTA BARBARA, CA 93105
(805) 886-8021
(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
01
1043211907
ORGANIZATION NPI
Enumeration date
08/02/2005
Last updated
12/28/2023
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