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General NPI Number Information
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NPI Number | 1679726095
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Entity Type | Organization
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Legal Business Name | OPTIMAL HEALTH PRIMARY CARE BROWN PC
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 10120 S EASTERN AVE STE 100
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City | HENDERSON
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State | NV
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Zip | 89052-3952
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Country | US
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Telephone | 702-871-7004
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Fax | 702-871-7005
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Provider Business Mailing Address
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Address Line | 10120 S EASTERN AVE STE 100
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City | HENDERSON
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State | NV
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Zip | 89052-3952
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Country | US
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Telephone | 702-871-7004
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Fax | 702-871-7005
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY L BROWN
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Credential | DO
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Telephone | 702-871-7004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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