Provider Demographics
NPI:1285020487
Name:BROWNELL, NICHOLAS KEISUKE (MD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:KEISUKE
Last Name:BROWNELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DIVISION OF CARDIOLOGY
Mailing Address - Street 2:650 CHARLES E. YOUNG DRIVE SOUTH, A2-237 CHS
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095
Mailing Address - Country:US
Mailing Address - Phone:310-825-9011
Mailing Address - Fax:310-206-9133
Practice Address - Street 1:650 CHARLES E YOUNG DR S
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-8347
Practice Address - Country:US
Practice Address - Phone:310-825-9011
Practice Address - Fax:102-069-1333
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA162562207RC0000X
TXR4524208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease