Provider Demographics
NPI:1124121413
Name:BROWN, STEVEN G (MS PT)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:G
Last Name:BROWN
Suffix:
Gender:M
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:96020
Mailing Address - Country:US
Mailing Address - Phone:530-258-1986
Mailing Address - Fax:
Practice Address - Street 1:130 BRENTWOOD DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:CA
Practice Address - Zip Code:96020
Practice Address - Country:US
Practice Address - Phone:530-258-1986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAS80185174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOPT18494Medicaid
CAOPT184940Medicare ID - Type Unspecified