MEDICARE: DAVID JOHN BROWN DDS

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	1223G0001X	General Practice Dentistry	35375	CA

General Provider Information

NPI Number	:	1326140757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID JOHN BROWN DDS

Provider Business Mailing Address
First Line	:	7119 WEST MANCHESTER AVENUE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045
Country	:	US
Telephone Number	:	310-670-4121
Fax Number	:	310-670-2927

Provider Business Practice Location Address
First Line	:	7119 WEST MANCHESTER AVENUE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045
Country	:	US
Telephone Number	:	310-670-4121
Fax Number	:	310-670-2927

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

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	07/08/2007

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