Healthcare Provider Details

I. General information

NPI: 1871554592
Provider Name (Legal Business Name): RICHARD N BROWNSBERGER P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 11/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

488 E VALLEY PKWY SUITE 404
ESCONDIDO CA
92025-3363
US

IV. Provider business mailing address

PO BOX 462750
ESCONDIDO CA
92046-2750
US

V. Phone/Fax

Practice location:
  • Phone: 760-739-7666
  • Fax: 760-739-7633
Mailing address:
  • Phone: 760-520-8500
  • Fax: 760-520-8523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA18269
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA18269
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: