Healthcare Provider Details

I. General information

NPI: 1467496919
Provider Name (Legal Business Name): MONICA BROWN MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 03/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17516 SATICOY ST # 525
VAN NUYS CA
91406-2333
US

IV. Provider business mailing address

17516 SATICOY ST # 525
VAN NUYS CA
91406-2333
US

V. Phone/Fax

Practice location:
  • Phone: 818-000-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberA84923
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA84923
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: