Provider Demographics
NPI:1104023902
Name:BROOKS, AL (MD)
Entity Type:Individual
Prefix:
First Name:AL
Middle Name:
Last Name:BROOKS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:AL BROOKS C/O WILL JONES, MST
Mailing Address - Street 2:2377 GOLD MEADOW WAY, STE. 100
Mailing Address - City:GOLD RIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95670
Mailing Address - Country:US
Mailing Address - Phone:916-586-8999
Mailing Address - Fax:
Practice Address - Street 1:AL BROOKS C/O WILL JONES, MST
Practice Address - Street 2:2377 GOLD MEADOW WAY, STE. 100
Practice Address - City:GOLD RIVER
Practice Address - State:CA
Practice Address - Zip Code:95670
Practice Address - Country:US
Practice Address - Phone:916-586-8999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2022-01-24
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Provider Licenses
StateLicense IDTaxonomies
CAG47145207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG47145OtherMEDICAL LICENSE