Provider Demographics
NPI:1508445859
Name:WESTBROOK, KEVIN BRECK (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:BRECK
Last Name:WESTBROOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2755 ALAMO ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-1311
Mailing Address - Country:US
Mailing Address - Phone:805-988-7070
Mailing Address - Fax:
Practice Address - Street 1:2755 ALAMO ST STE 201
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-1311
Practice Address - Country:US
Practice Address - Phone:805-988-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA196164207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine