Healthcare Provider Details

I. General information

NPI: 1932399193
Provider Name (Legal Business Name): HEIDI WENDELL BROWN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIDI WENDELL BROWN FILIPPONE MD

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 05/03/2025
Certification Date: 05/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 FORDHAM ST
SAN DIEGO CA
92110-5339
US

IV. Provider business mailing address

3250 FORDHAM ST
SAN DIEGO CA
92110-5339
US

V. Phone/Fax

Practice location:
  • Phone: 619-221-0350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number60907
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number60907
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberA110956
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: