Provider Demographics
NPI:1629159397
Name:BROWN, HOSEA III (MD)
Entity Type:Individual
Prefix:DR
First Name:HOSEA
Middle Name:
Last Name:BROWN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27062 LA PAZ RD
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-3041
Mailing Address - Country:US
Mailing Address - Phone:949-362-8877
Mailing Address - Fax:949-389-9564
Practice Address - Street 1:27062 LA PAZ RD
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3041
Practice Address - Country:US
Practice Address - Phone:949-362-8877
Practice Address - Fax:949-389-9564
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG45164207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG45164Medicare ID - Type Unspecified
CAA49917Medicare UPIN