Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 32105 | CA |
N | 111NR0200X | Radiology | 32105 | CA |
N | 213ER0200X | Radiology | 32105 | CA |
NPI | 1558645796 |
---|---|
Provider Name | Dr. Alex L Brown |
First Address | Santa Rosa, CA 95404-3202 |
Second Address | Santa Rosa, CA 95404-3202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2011 |
Last Update Date | 06/10/2011 |