Provider Demographics
NPI:1083850986
Name:PHILLIP D. BROWN D.C., A.P.C.
Entity Type:Organization
Organization Name:PHILLIP D. BROWN D.C., A.P.C.
Other - Org Name:BIOLOGICS HEALTH & SPORTS INJURY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-841-5588
Mailing Address - Street 1:16168 BEACH BLVD
Mailing Address - Street 2:SUITE 135
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3816
Mailing Address - Country:US
Mailing Address - Phone:714-841-5588
Mailing Address - Fax:714-841-2564
Practice Address - Street 1:16168 BEACH BLVD
Practice Address - Street 2:SUITE 135
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3816
Practice Address - Country:US
Practice Address - Phone:714-841-5588
Practice Address - Fax:714-841-2564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20530111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
421178Medicare UPIN