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NPI Code Detail

MEDICARE: DAMON BROWN PHYSICAL THERAPY

MEDICARE: DAMON BROWN PHYSICAL THERAPY
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
1225100000XPhysical Therapist16935CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OPT169350OTHERCABLUE SHIELD
216935OTHERCABLUE CROSS

General Provider Information

NPI Number : 1992839260
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAMON BROWN PHYSICAL THERAPY
Provider Business Mailing Address
First Line : 822 S ROBERTSON BLVD
Second Line : SUITE 310
City : LOS ANGELES
State : CA
Zip : 90035-1613
Country : US
Telephone Number : 310-360-9069
Fax Number : 310-360-0840
Provider Business Practice Location Address
First Line : 822 S ROBERTSON BLVD
Second Line : SUITE 310
City : LOS ANGELES
State : CA
Zip : 90035-1613
Country : US
Telephone Number : 310-360-9069
Fax Number : 310-360-0840
Authorized Official
Title or Position : PHYSICAL THERAPIST, OWNER
Name : MR. DAMON BROWN
Credential : P.T., O.C.S.
Telephone Number : 310-360-9069
Provider Enumeration Date : 03/16/2007
Last Update Date : 08/22/2020

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Directions to “DAMON BROWN PHYSICAL THERAPY ” Practice Location

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