Provider Demographics
NPI:1023248457
Name:BROWN, KALEY MICHELLE (PA)
Entity type:Individual
Prefix:
First Name:KALEY
Middle Name:MICHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4060 4TH AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2121
Mailing Address - Country:US
Mailing Address - Phone:619-299-8500
Mailing Address - Fax:619-299-1948
Practice Address - Street 1:4060 4TH AVE STE 700
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2121
Practice Address - Country:US
Practice Address - Phone:619-299-8500
Practice Address - Fax:619-299-1948
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA20374363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical