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Physician Compare National (NPI:1124210018)

HEALTHCARE PROVIDER: SPENCER LELAND BROWN M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1124210018
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 3173657616
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20100818001328
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name BROWN
Individual professional last name
Provider First Name SPENCER
Individual professional first name
Provider Middle Name L
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name BOSTON UNIVERSITY SCHOOL OF MEDICINE
Individual professional's medical school
Graduation Year 1980
Individual professional's medical school graduation year
Primary Specialty GENERAL SURGERY
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 VASCULAR SURGERY
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties VASCULAR SURGERY
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Line 1 Street Address 6076 BRISTOL PKWY
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 108
Group Practice or individual's line 2 address
City CULVER CITY
Group Practice or individual's city
State CA
Group Practice or individual's state
Zip Code 902306600
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 050135
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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