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NPI Code Detail

MEDICARE: DR. CHARLES VICTOR BROWN JR. M.D.

MEDICARE:  DR. CHARLES VICTOR BROWN JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207UN0902XNuclear Imaging & Therapy PhysicianA49923CA
2208D00000XGeneral Practice PhysicianA49923CA

General Provider Information

NPI Number : 1124023759
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES VICTOR BROWN JR. M.D.
Provider Business Mailing Address
First Line : PO BOX 84524
Second Line :
City : LOS ANGELES
State : CA
Zip : 90073-0524
Country : US
Telephone Number : 310-696-9522
Fax Number :
Provider Business Practice Location Address
First Line : 1249 W GARDENA BLVD
Second Line : STE 102
City : GARDENA
State : CA
Zip : 90247-4884
Country : US
Telephone Number : 310-538-0400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 09/11/2025

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Directions to “ DR. CHARLES VICTOR BROWN JR. M.D.” Practice Location

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