Provider Demographics
NPI:1245424365
Name:BROOK, SCOTT DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:DAVID
Last Name:BROOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 3303
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92263-3303
Mailing Address - Country:US
Mailing Address - Phone:760-416-4721
Mailing Address - Fax:760-416-4875
Practice Address - Street 1:1180 N INDIAN CANYON DR
Practice Address - Street 2:SUIT E-218
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4800
Practice Address - Country:US
Practice Address - Phone:760-416-4721
Practice Address - Fax:760-416-4875
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2011-08-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA116376207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA116376OtherMEDICAL LICENSE