Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | G30457 | CA |
NPI | 1770594749 |
---|---|
Provider Name | Dr. Lorenzo Simone Brown |
First Address | Inglewood, CA 90301-1812 |
Second Address | Inglewood, CA 90301-1812 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 10/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G30470 | (05) | CA |
040007086 | RAILROAD MEDICARE (01) | CA |
A44431 | (02) |