MEDICARE: CHONDRA L BROWN

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	225700000X	Massage Therapist	D3484040	CA

General Provider Information

NPI Number	:	1427919075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHONDRA L BROWN

Provider Business Mailing Address
First Line	:	20461 FORTUNA DEL SUR
Second Line	:
City	:	ELFIN FOREST
State	:	CA
Zip	:	92029-4505
Country	:	US
Telephone Number	:	760-612-9458
Fax Number	:

Provider Business Practice Location Address
First Line	:	20461 FORTUNA DEL SUR
Second Line	:
City	:	ELFIN FOREST
State	:	CA
Zip	:	92029-4505
Country	:	US
Telephone Number	:	760-612-9458
Fax Number	:

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

Provider Enumeration Date	:	11/22/2025
Last Update Date	:	11/22/2025

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Directions to “ CHONDRA L BROWN ” Practice Location

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