Provider Demographics
NPI:1003180050
Name:STEWART W BROWN, M.D., INC.
Entity Type:Organization
Organization Name:STEWART W BROWN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEWART
Authorized Official - Middle Name:WILBUR
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-429-8830
Mailing Address - Street 1:1777 N BELLFLOWER BLVD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-4013
Mailing Address - Country:US
Mailing Address - Phone:562-429-8830
Mailing Address - Fax:562-429-4679
Practice Address - Street 1:1777 N BELLFLOWER BLVD
Practice Address - Street 2:SUITE 209
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-4013
Practice Address - Country:US
Practice Address - Phone:562-429-8830
Practice Address - Fax:562-429-4679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG28389207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G283890Medicaid
CAG28389Medicare PIN