Provider Demographics
NPI:1437361789
Name:BROWN, PAUL HARRISON (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:HARRISON
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2137 E OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92661-1522
Mailing Address - Country:US
Mailing Address - Phone:949-673-5786
Mailing Address - Fax:949-673-5786
Practice Address - Street 1:750 N DIAMOND BAR BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1023
Practice Address - Country:US
Practice Address - Phone:909-861-4663
Practice Address - Fax:909-861-5283
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA265022084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA265020OtherMEDICAL LICENSE
CAA265020OtherMEDICAL LICENSE