Healthcare Provider Details

I. General information

NPI: 1700748456
Provider Name (Legal Business Name): CHAN BROWN BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 STEVENS AVE
SOLANA BEACH CA
92075-2054
US

IV. Provider business mailing address

1211 STONEMARK PL # 1
VISTA CA
92081-0003
US

V. Phone/Fax

Practice location:
  • Phone: 209-259-9270
  • Fax:
Mailing address:
  • Phone: 209-259-9270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95297578
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: