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Individual

JERRELL SCOTT BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1650 CREEKSIDE DR, FOLSOM, CA 95630-3400
(916) 983-7561
(916) 984-7392
Mailing address
PO BOX 1809, ORANGE, CA 92856-0809
(714) 560-1580
(714) 560-1585

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G063511
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G635110
BLUE SHIELD
CA
05
00G635111
CA
Enumeration date
07/31/2006
Last updated
06/12/2013
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