Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 294309 | CA |
Y | 213ES0000X | Sports Medicine | 294309 | CA |
NPI | 1306344569 |
---|---|
Provider Name | Sara Elizabeth Brown |
First Address | Santa Cruz, CA 95062-2839 |
Second Address | Santa Cruz, CA 95062-1434 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2018 |
Last Update Date | 23/01/2018 |