MEDICARE: DR. JEFFREY BROWN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	G21361	CA

General Provider Information

NPI Number	:	1902815657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY BROWN MD

Provider Business Mailing Address
First Line	:	1204 SHARON PARK DR APT 81
Second Line	:
City	:	MENLO PARK
State	:	CA
Zip	:	94025-7041
Country	:	US
Telephone Number	:	408-998-5811
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 WOOD RD
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95030-6737
Country	:	US
Telephone Number	:	408-998-5811
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/08/2007

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