Basic Information
Provider Information
NPI: 1780078501
EntityType: 2
ReplacementNPI:  
OrganizationName: ADAM B BROWN, DO,INC
LastName:  
FirstName:  
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NameSuffix:  
Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: PO BOX 7001
Address2:  
City: TARZANA
State: CA
PostalCode: 913577001
CountryCode: US
TelephoneNumber: 8188887815
FaxNumber:  
Practice Location
Address1: 436 N BEDFORD DR
Address2:  
City: BEVERLY HILLS
State: CA
PostalCode: 902104310
CountryCode: US
TelephoneNumber: 3102788200
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/19/2015
LastUpdateDate: 03/25/2015
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: BROWN
AuthorizedOfficialFirstName: ADAM
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AuthorizedOfficialTitleorPosition: SOLE OWNER
AuthorizedOfficialTelephone: 8188887815
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: D.O.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X20A9224CAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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