Provider Demographics
NPI:1467498758
Name:BROWN, TANYA (MD)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:BROWN
Other - Last Name:RANDHAWA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8953 GARDEN HWY
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-9411
Mailing Address - Country:US
Mailing Address - Phone:530-680-8306
Mailing Address - Fax:530-680-8306
Practice Address - Street 1:9792 LIVE OAK BLVD STE B
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:CA
Practice Address - Zip Code:95953-2381
Practice Address - Country:US
Practice Address - Phone:530-680-8306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG87823207P00000X, 208600000X, 208D00000X
NY175935207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPENDINGMedicaid
NYF99131Medicare UPIN
CAPENDINGMedicare PIN
NY3341H1Medicare ID - Type Unspecified