Provider Demographics
NPI:1497372536
Name:KALEY BROWN SURGICAL PA
Entity Type:Organization
Organization Name:KALEY BROWN SURGICAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:619-997-7720
Mailing Address - Street 1:360 TOM MCGUINNESS JR CIR
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-2623
Mailing Address - Country:US
Mailing Address - Phone:619-997-7720
Mailing Address - Fax:
Practice Address - Street 1:360 TOM MCGUINNESS JR CIR
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-2623
Practice Address - Country:US
Practice Address - Phone:619-997-7720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-05
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty