Individual
BETH A BROWN
Active
Individual
BETH A BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
22240
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083124
NAT'L COMM OF CERTIFICATION OF PHYSICIAN ASSISTANTS
CA
01
—
12380925
CAQH PROVIDER NUMBER
CA
01
—
22240
DCA: PHYSICIAN ASSISTANT COMMITTEE LICENSE
CA
Enumeration date
09/29/2009
Last updated
06/05/2012
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