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General NPI Number Information
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NPI Number | 1457616997
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Entity Type | Individual
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Provider Name | MARISSA LYN BROWN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 250 TRAVELODGE DRIVE
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City | EL CAJON
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State | CA
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Zip | 92020
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Country | US
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Telephone | 619-528-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 250 TRAVELODGE DRIVE
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City | EL CAJON
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State | CA
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Zip | 92020
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Country | US
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Telephone | 619-528-5000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 207ZP0102X
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A142166
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License Number State | CA
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