Healthcare Provider Details

I. General information

NPI: 1497372536
Provider Name (Legal Business Name): KALEY BROWN SURGICAL PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2020
Last Update Date: 07/13/2020
Certification Date: 07/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 TOM MCGUINNESS JR CIR
FALLBROOK CA
92028-2623
US

IV. Provider business mailing address

360 TOM MCGUINNESS JR CIR
FALLBROOK CA
92028-2623
US

V. Phone/Fax

Practice location:
  • Phone: 619-997-7720
  • Fax:
Mailing address:
  • Phone: 619-997-7720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: KALEY BROWN
Title or Position: OWNER
Credential: PA
Phone: 619-997-7720