Healthcare Provider Details

I. General information

NPI: 1013399559
Provider Name (Legal Business Name): BRANDON SCOTT BROWN M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BRANDON SCOTT BROWN MD, PHD

II. Dates (important events)

Enumeration Date: 06/21/2015
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1388 BUCKMAN SPRINGS RD
CAMPO CA
91906-2028
US

IV. Provider business mailing address

1601 PRECISION PARK LN
SAN DIEGO CA
92173-1345
US

V. Phone/Fax

Practice location:
  • Phone: 619-662-4100
  • Fax:
Mailing address:
  • Phone: 619-662-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA148499
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberV1414
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-20782
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: