Provider Demographics
NPI:1659473486
Name:BROWN, JAMES C JR (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:GRIDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95948-2215
Mailing Address - Country:US
Mailing Address - Phone:530-846-5655
Mailing Address - Fax:530-846-3784
Practice Address - Street 1:225 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GRIDLEY
Practice Address - State:CA
Practice Address - Zip Code:95948-2215
Practice Address - Country:US
Practice Address - Phone:530-846-5655
Practice Address - Fax:530-846-3784
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2OA5317207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ37088ZMedicare PIN
CAF14389Medicare UPIN