Provider Demographics
NPI:1235459827
Name:BROWN, ANTONIO R (MPA-C, MPH)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:R
Last Name:BROWN
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Gender:M
Credentials:MPA-C, MPH
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Other - First Name:
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Mailing Address - Street 1:7851 MISSION CENTER CT
Mailing Address - Street 2:#112
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1325
Mailing Address - Country:US
Mailing Address - Phone:858-737-1763
Mailing Address - Fax:858-737-1766
Practice Address - Street 1:7851 MISSION CENTER CT
Practice Address - Street 2:#112
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1325
Practice Address - Country:US
Practice Address - Phone:858-737-1763
Practice Address - Fax:858-737-1766
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA20967363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant