Provider Demographics
NPI:1215216049
Name:KENNETH C BROWNING, D.O., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:KENNETH C BROWNING, D.O., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-784-6472
Mailing Address - Street 1:4315 BROCKTON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-3448
Mailing Address - Country:US
Mailing Address - Phone:951-784-6472
Mailing Address - Fax:951-784-5732
Practice Address - Street 1:4315 BROCKTON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3448
Practice Address - Country:US
Practice Address - Phone:951-784-6472
Practice Address - Fax:951-784-5732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A4663207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty