Organization
IVAN I. BROOKS, A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVAN ISREAL BROOKS M.D. (PRESIDENT)
(310) 351-3876
Entity
Organization
Contact information
Practice address
8670 WILSHIRE BLVD, #300, BEVERLY HILLS, CA 90211-2924
(310) 275-1646
(310) 275-4294
Mailing address
225 S LAKE AVE, #535, PASADENA, CA 91101-3005
(626) 795-6596
(626) 795-8247
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A653210
BLUE SHIELD
CA
Enumeration date
08/05/2006
Last updated
03/10/2008
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