Healthcare Provider Details

I. General information

NPI: 1508889882
Provider Name (Legal Business Name): SHELDON CHARLES BROWN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CASTLE PARK WAY
OAKLAND CA
94611
US

IV. Provider business mailing address

1 CASTLE PARK WAY
OAKLAND CA
94611-2745
US

V. Phone/Fax

Practice location:
  • Phone: 510-843-3400
  • Fax:
Mailing address:
  • Phone: 510-843-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberC24282
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: