Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XH1200X | Occupational Therapist - Hand | OT 1316 | CA |
Y | 225XH1200X | Occupational Therapist - Hand | OT1316 | CA |
NPI | 1033260989 |
---|---|
Provider Name | Judson P Brown |
First Address | Mission Viejo, CA 92691-6378 |
Second Address | Mission Viejo, CA 92691-6378 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 22/02/2013 |