Provider Demographics
NPI:1821187857
Name:BROWNSTONE, DEBORAH LAURA (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LAURA
Last Name:BROWNSTONE
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 1:657 CAMINO DE LOS MARES
Mailing Address - Street 2:SUITE 137
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-2826
Mailing Address - Country:US
Mailing Address - Phone:949-489-9039
Mailing Address - Fax:
Practice Address - Street 1:657 CAMINO DE LOS MARES
Practice Address - Street 2:SUITE 137
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-2826
Practice Address - Country:US
Practice Address - Phone:949-489-9039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42853174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA42853OtherCALIFORNIA STATE LICENSE
CA00A428530Medicaid
1538282520OtherGROUP NPI
CA00A428530Medicaid
CAA42853OtherCALIFORNIA STATE LICENSE