Provider Demographics
NPI:1265406813
Name:BROWN, THERESA A (NP)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:A
Last Name:BROWN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:23101 SHERMAN PL
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-2003
Mailing Address - Country:US
Mailing Address - Phone:818-702-8800
Mailing Address - Fax:818-702-0080
Practice Address - Street 1:23101 SHERMAN PL
Practice Address - Street 2:SUITE 110
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-2003
Practice Address - Country:US
Practice Address - Phone:818-702-8800
Practice Address - Fax:818-702-0080
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA334028207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA12863OtherNP NUMBER