Healthcare Provider Details

I. General information

NPI: 1235523515
Provider Name (Legal Business Name): LAURA ELIZABETH BROWN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 04/09/2021
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 BERRY ST STE 290
SAN FRANCISCO CA
94107-1773
US

IV. Provider business mailing address

185 BERRY ST STE 290
SAN FRANCISCO CA
94107-1773
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1667
  • Fax:
Mailing address:
  • Phone: 805-300-1697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA154688
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: