Provider Demographics
NPI:1730464389
Name:MCQUOWN, BROOK DOUGLAS
Entity type:Individual
Prefix:MR
First Name:BROOK
Middle Name:DOUGLAS
Last Name:MCQUOWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44630 MONTEREY AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-3326
Mailing Address - Country:US
Mailing Address - Phone:760-340-4290
Mailing Address - Fax:760-340-9726
Practice Address - Street 1:44630 MONTEREY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3326
Practice Address - Country:US
Practice Address - Phone:760-340-4290
Practice Address - Fax:760-340-9726
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA3664237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist