Provider Demographics
NPI:1588108732
Name:TOMPKINS, BROOKE ASHLEY (PA-C)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ASHLEY
Last Name:TOMPKINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3990 CENTRE ST
Mailing Address - Street 2:UNIT 103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3489
Mailing Address - Country:US
Mailing Address - Phone:858-603-3751
Mailing Address - Fax:
Practice Address - Street 1:9850 GENESEE AVE STE 410
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1212
Practice Address - Country:US
Practice Address - Phone:858-550-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53771363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical