Provider Demographics
NPI:1942283007
Name:BROWN, DAMON MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:DAMON
Middle Name:MARK
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12242 BUSINESS PARK DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-3321
Mailing Address - Country:US
Mailing Address - Phone:530-587-8458
Mailing Address - Fax:
Practice Address - Street 1:12242 BUSINESS PARK DR
Practice Address - Street 2:SUITE 4
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-3321
Practice Address - Country:US
Practice Address - Phone:530-587-8458
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT17758Medicare ID - Type Unspecified