Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E4434 | CA |
Y | 222Z00000X | Podiatrist | E4434 | CA |
NPI | 1073513610 |
---|---|
Provider Name | Dr. James Francis Brown |
First Address | Los Angeles, CA 90074-0001 |
Second Address | La Jolla, CA 92037-1027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 01/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E4434 | (05) | CA |
P00728792 | RRM (01) | CA |
U92705 | (02) | CA |