MEDICARE: BRENDA THINNES BROWN MSPAS, MPH, PA-C

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
1	363A00000X	Physician Assistant	PA22305	CA

General Provider Information

NPI Number	:	1194073312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA THINNES BROWN MSPAS, MPH, PA-C

Provider Business Mailing Address
First Line	:	7525 LINDA VISTA RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-5344
Country	:	US
Telephone Number	:	858-650-3030
Fax Number	:

Provider Business Practice Location Address
First Line	:	7525 LINDA VISTA RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-5344
Country	:	US
Telephone Number	:	858-650-3030
Fax Number	:	185-860-3033

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2012
Last Update Date	:	11/29/2021

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