1619295862 NPI number — DR. NEAL JAY BROWN DDS

Table of content: DR. NEAL JAY BROWN DDS (NPI 1619295862)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619295862 NPI number — DR. NEAL JAY BROWN DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
NEAL
Provider Middle Name:
JAY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
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:
1619295862
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/12/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10800 PARAMOUNT BLVD
Provider Second Line Business Mailing Address:
STE 407 NEAL J BROWN DDS
Provider Business Mailing Address City Name:
DOWNEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90241
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-869-2096
Provider Business Mailing Address Fax Number:
562-869-3161

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10800 PARAMOUNT BLVD
Provider Second Line Business Practice Location Address:
STE 407 NEAL J BROWN DDS
Provider Business Practice Location Address City Name:
DOWNEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-869-2096
Provider Business Practice Location Address Fax Number:
562-869-3161
Provider Enumeration Date:
05/12/2010

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: 122300000X , with the licence number:  42279 , 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)