MEDICARE: MS. AMBER QUIROGA BROWN RN

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	163WC0400X	Case Management Registered Nurse	95025590	CA
2	163WG0600X	Gerontology Registered Nurse	95025590	CA
3	163WH0200X	Home Health Registered Nurse	95025590	CA

General Provider Information

NPI Number	:	1477095529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMBER QUIROGA BROWN RN

Provider Business Mailing Address
First Line	:	333 W BROADWAY
Second Line	:	# 1796
City	:	ANAHEIM
State	:	CA
Zip	:	92815-2000
Country	:	US
Telephone Number	:	949-546-9473
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 W BROADWAY
Second Line	:	# 1796
City	:	ANAHEIM
State	:	CA
Zip	:	92815-2000
Country	:	US
Telephone Number	:	949-546-9473
Fax Number	:

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

Provider Enumeration Date	:	11/07/2016
Last Update Date	:	11/07/2016

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