Provider Demographics
NPI:1073597738
Name:BROWN, JAMES ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8360 RED OAK ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0607
Mailing Address - Country:US
Mailing Address - Phone:909-980-1946
Mailing Address - Fax:909-980-1625
Practice Address - Street 1:8360 RED OAK ST
Practice Address - Street 2:SUITE 103
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0607
Practice Address - Country:US
Practice Address - Phone:909-980-1946
Practice Address - Fax:909-980-1625
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2012-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA51937207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A519370Medicare ID - Type Unspecified
CAF72028Medicare UPIN