Provider Demographics
NPI:1750589149
Name:BROWN, EMEM E (PA-C)
Entity type:Individual
Prefix:
First Name:EMEM
Middle Name:E
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:742 WEST GARDENA BLVD.
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247
Mailing Address - Country:US
Mailing Address - Phone:310-327-1357
Mailing Address - Fax:310-327-5386
Practice Address - Street 1:742 WEST GARDENA BLVD
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-3817
Practice Address - Country:US
Practice Address - Phone:310-327-1357
Practice Address - Fax:310-327-5386
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
CAPA19245363AM0700X
CA19245363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical