Provider Demographics
NPI:1003422486
Name:NICHOLAS PATRICK BROWN, DO
Entity Type:Organization
Organization Name:NICHOLAS PATRICK BROWN, DO
Other - Org Name:MBS INTEGRATIVE PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:530-435-5048
Mailing Address - Street 1:214 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT SHASTA
Mailing Address - State:CA
Mailing Address - Zip Code:96067-2331
Mailing Address - Country:US
Mailing Address - Phone:530-435-5048
Mailing Address - Fax:602-603-5084
Practice Address - Street 1:214 E LAKE ST
Practice Address - Street 2:
Practice Address - City:MOUNT SHASTA
Practice Address - State:CA
Practice Address - Zip Code:96067-2331
Practice Address - Country:US
Practice Address - Phone:530-435-5048
Practice Address - Fax:602-603-5084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty