Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A 108632 | CA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | A 108632 | CA |
NPI | 1174712962 |
---|---|
Provider Name | Dr. Robert J. Brown |
First Address | Los Angeles, CA 90027-6016 |
Second Address | Los Angeles, CA 90027-6016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2007 |
Last Update Date | 20/11/2020 |