Individual
MR. GARY LEE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2585 SAMARITAN DRIVE, SAN JOSE, CA 95124-4107
(408) 371-6771
(408) 371-6387
Mailing address
3803 S BASCOM AVE, CAMPBELL, CA 95008-7317
(408) 278-3000
(408) 266-7232
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA11381
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1012194
NCCPA
CA
Enumeration date
01/15/2007
Last updated
09/13/2016
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