Provider Demographics
NPI:1508889882
Name:BROWN, SHELDON CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:CHARLES
Last Name:BROWN
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 1:1 CASTLE PARK WAY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2745
Mailing Address - Country:US
Mailing Address - Phone:510-843-3400
Mailing Address - Fax:
Practice Address - Street 1:1 CASTLE PARK WAY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611
Practice Address - Country:US
Practice Address - Phone:510-843-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC24282174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C242820Medicaid
CA00C242820Medicare ID - Type UnspecifiedSHELDON C. BROWN. M.D.