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Individual

ROBERT BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1400 EMELINE AVE, 1ST FLOOR, SANTA CRUZ, CA 95060-1976
(831) 454-4900
(831) 454-4663
Mailing address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-4900
(831) 454-4663

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
C50186
CA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
C50186
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00C501860
CA
01
BP970X
INDIVIDUAL MEDICARE PTAN#
CA
01
BP970Z
INDIVIDUAL MEDICARE PTAN#
CA
01
C50186
MEDICAL LICENSE#
CA
01
ZZZ91891Z
MEDICARE GROUP ID#
CA
01
ZZZ91892Z
MEDICARE GROUP ID#
CA
01
ZZZ92069Z
MEDICARE GROUP ID#
CA
Enumeration date
07/12/2006
Last updated
03/07/2023
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