Mr. Carson Demetruis Brooks II
Rehabilitation Practitioner
1126 N Grand Ave
Covina
, California 91724-1551
Mr. Carson Demetruis Brooks II
Rehabilitation Practitioner
1126 N Grand Ave
Covina
, California 91724-1551
(909) 887-4037
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About
Features
Specialties
- Rehabilitation Practitioner
Languages spoken
- English
Location
First Address
- Mr. Carson Demetruis Brooks II
- 6456 Youngstown Ln
- San Bernardino, CA
- Zip : 92407-2161
- Phone : (909) 887-4037
Second Address
- Mr. Carson Demetruis Brooks II
- 1126 N Grand Ave
- Covina, CA
- Zip : 91724-1551
- Phone : (626) 967-1667
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Is Mr. Carson Demetruis Brooks II a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner |
National Provider Identifier
| NPI | 1053518050 |
|---|---|
| Provider Name | Mr. Carson Demetruis Brooks II |
| First Address | San Bernardino, CA 92407-2161 |
| Second Address | Covina, CA 91724-1551 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/07/2007 |
| Last Update Date | 12/09/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.