Healthcare Provider Details

I. General information

NPI: 1144316878
Provider Name (Legal Business Name): JEFFRY ALLEN BROWN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 POSADA LN STE 202
TEMPLETON CA
93465-4060
US

IV. Provider business mailing address

1255 LAS TABLAS RD STE 201
TEMPLETON CA
93465-9750
US

V. Phone/Fax

Practice location:
  • Phone: 805-434-5497
  • Fax: 805-434-0917
Mailing address:
  • Phone: 805-434-5530
  • Fax: 805-434-0023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberG44931
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: