Provider Demographics
NPI:1831387083
Name:BRIAN M. BROWN, M.D., INC
Entity type:Organization
Organization Name:BRIAN M. BROWN, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MISENHELTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-904-1989
Mailing Address - Street 1:10933 LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3808
Mailing Address - Country:US
Mailing Address - Phone:562-904-1989
Mailing Address - Fax:
Practice Address - Street 1:10933 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3808
Practice Address - Country:US
Practice Address - Phone:562-904-1989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52712207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6179150001Medicare NSC
CAW19617Medicare PIN