Provider Demographics
NPI:1376519561
Name:BROOKS, ANDREW T (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:T
Last Name:BROOKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 NUT TREE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-4172
Mailing Address - Country:US
Mailing Address - Phone:707-624-7900
Mailing Address - Fax:707-624-7901
Practice Address - Street 1:1010 NUT TREE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4172
Practice Address - Country:US
Practice Address - Phone:707-624-7900
Practice Address - Fax:707-624-7901
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60076207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA200024299OtherRAILROAD MEDICARE INDIVIDUAL PTAN
CA200024299OtherRAILROAD MEDICARE INDIVIDUAL PTAN
CAF24439Medicare UPIN