Individual
MARTELL BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4619 ROSEMEAD BLVD, ROSEMEAD, CA 91770-1478
(626) 286-1191
Mailing address
4619 ROSEMEAD BLVD, ROSEMEAD, CA 91770-1478
(626) 286-1191
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
42170
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42170
N/A
CA
Enumeration date
03/01/2022
Last updated
03/01/2022
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