Provider Demographics
NPI:1891787289
Name:BROWN, HOSEA E (MD)
Entity Type:Individual
Prefix:DR
First Name:HOSEA
Middle Name:E
Last Name:BROWN
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:PO BOX 1503
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92263-1503
Mailing Address - Country:US
Mailing Address - Phone:760-320-9464
Mailing Address - Fax:760-320-6244
Practice Address - Street 1:1276 N PALM CANYON DR
Practice Address - Street 2:SUITE 110
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4411
Practice Address - Country:US
Practice Address - Phone:760-320-9464
Practice Address - Fax:760-320-6244
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG33523207KA0200X
AZ24719207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ365975Medicaid
AZAZ0803500OtherBLUE CROSS BLUE SHIELD
CA00G335230Medicaid
CAA45580Medicare UPIN
AZMD24719Medicare PIN
AZ365975Medicaid