Individual
MS. BROOKE TAYLOR OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
23961 CALLE DE LA MAGDALENA STE 300, LAGUNA HILLS, CA 92653-3665
(949) 951-2020
Mailing address
23961 CALLE DE LA MAGDALENA STE 300, LAGUNA HILLS, CA 92653-3665
(949) 951-2020
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
PA21175
CA
Other
Enumeration date
12/17/2010
Last updated
08/19/2021
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