Individual
TARA L BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11770 BERNARDO PLAZA COURT, SUITE 315, SAN DIEGO, CA 92128
(858) 487-5090
(619) 460-2184
Mailing address
11770 BERNARDO PLAZA COURT, SUITE 315, SAN DIEGO, CA 92128
(858) 487-5090
(619) 460-2184
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A85440
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0802380001
MEDICARE DME
CA
01
—
0802400001
MEDICARE DME
CA
Enumeration date
10/12/2006
Last updated
01/25/2017
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