Provider Demographics
NPI:1710109699
Name:BROWN, ELLEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 N MARY AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-2905
Mailing Address - Country:US
Mailing Address - Phone:408-730-5900
Mailing Address - Fax:408-730-8716
Practice Address - Street 1:585 N MARY AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-2905
Practice Address - Country:US
Practice Address - Phone:408-730-5900
Practice Address - Fax:408-730-8716
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG57759207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG57759OtherSTATE LICENSE