1710965462 NPI number — DR. TIMOTHY D BROWDER M.D.

Table of content: DR. TIMOTHY D BROWDER M.D. (NPI 1710965462)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710965462 NPI number — DR. TIMOTHY D BROWDER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWDER
Provider First Name:
TIMOTHY
Provider Middle Name:
D
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710965462
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/28/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 PASTEUR DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STANFORD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94305-2200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-723-4000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 PASTEUR DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STANFORD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94305-2200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-723-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  A96189 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 11045 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086S0127X , with the licence number: 11045 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2086S0102X , with the licence number: A96189 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 880330858 . This is a "CHOICE CARE/HUMANA" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 880330858 . This is a "SIERRA HEALTH SERVICES" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 880330858 . This is a "AFFILIATED HEALTH FUNDS" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 880330858 . This is a "HORIZON/MCC" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 880330858 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 880330858 . This is a "CIGNA" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 880330858 . This is a "PACIFICARE" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 880330858 . This is a "UNIVERSAL HEALTH NETWORK" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: XPY206416 . This is a "MEDI-CAL" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 5590203 . This is a "FIRST HEALTH/CCN" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 880330858 . This is a "PHCS" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 916702 . This is a "AHCCCS" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 9217630 . This is a "MULTIPLAN" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 100505405 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 880330858 . This is a "BEECH STREET" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 880330858 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 964190 . This is a "USA/MCO HEALTH NETWORK" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".