Provider Demographics
NPI:1629176284
Name:BROWNE, RICHARD BLACKMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BLACKMAR
Last Name:BROWNE
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 1:420 CANON DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-2643
Mailing Address - Country:US
Mailing Address - Phone:805-682-4797
Mailing Address - Fax:805-682-3415
Practice Address - Street 1:147 N BRENT ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2809
Practice Address - Country:US
Practice Address - Phone:805-652-5011
Practice Address - Fax:805-585-3007
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG25064146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ53994ZOtherBLUE SHIELD
CAZZZA56032OtherBLUE SHIELD
CAG25064OtherCALIFORNIA LICENSE NUMBER
CA050394OtherBLUE CROSS
CAHSC30394FMedicaid
CAZZT40394FMedicaid
CAZZZ53994ZOtherBLUE SHIELD
CAG25064OtherCALIFORNIA LICENSE NUMBER
CAA42506Medicare UPIN