Provider Demographics
NPI:1457394926
Name:BROWN, WILLIAM HERBERT III (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HERBERT
Last Name:BROWN
Suffix:III
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 1:1032 CANADA RD
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:94062-3507
Mailing Address - Country:US
Mailing Address - Phone:650-703-9694
Mailing Address - Fax:
Practice Address - Street 1:39470 PASEO PADRE PKWY
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2310
Practice Address - Country:US
Practice Address - Phone:510-793-2404
Practice Address - Fax:510-793-1320
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG46351208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG46751OtherCALIFORNIA MEDICAL LICENS
CA00G463510Medicare ID - Type Unspecified
CAG46751OtherCALIFORNIA MEDICAL LICENS