Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brock Evan Booth

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1194287862

Brock Evan Booth is a Family Practice in Santa Ana, California. Graduated from Des Moines University of Osteopathic Medicine and Health Sciences in 2019, 7 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
7
Trained at
Des Moines University of Osteopathic Medicine and Health Sciences
In the registry since
2019
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Practice location Address checks out

1900 E 4th St
Santa Ana, CA 92705-3910
Phone: (714) 967-4766
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1194287862
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 2, 2019
Last updated in NPPESNovember 29, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolDES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Graduated 2019 (7 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Santa Ana