1306196159 NPI number — DR. ANDREW RICHARD MILNER BROWNLEE M.D.

Table of content: DR. ANDREW RICHARD MILNER BROWNLEE M.D. (NPI 1306196159)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306196159 NPI number — DR. ANDREW RICHARD MILNER BROWNLEE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWNLEE
Provider First Name:
ANDREW
Provider Middle Name:
RICHARD MILNER
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:
1306196159
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/18/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4140 W 190TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TORRANCE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90504-5513
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-967-1780
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8700 BEVERLY BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST HOLLYWOOD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90048-1804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-423-2640
Provider Business Practice Location Address Fax Number:
310-967-0669
Provider Enumeration Date:
09/19/2012

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208G00000X , with the licence number: A168783 , 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)





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