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NPI Code Detail

MEDICARE: DR. KRISTIN JOY AMENT BROWNELL MD

MEDICARE: DR. KRISTIN JOY AMENT BROWNELL MD
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
1207Q00000XFamily Medicine PhysicianA80154CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1FHC70267FOTHERMEDI-CAL

General Provider Information

NPI Number : 1134232259
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTIN JOY AMENT BROWNELL MD
Provider Business Mailing Address
First Line : 823 GATEWAY CENTER WAY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-4541
Country : US
Telephone Number : 619-515-2300
Fax Number : 619-906-4564
Provider Business Practice Location Address
First Line : 5454 EL CAJON BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92115-3621
Country : US
Telephone Number : 619-515-2400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2006
Last Update Date : 10/17/2017

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