MEDICARE: CALEB 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	172V00000X	Community Health Worker
2	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1588057970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALEB BROWN

Provider Business Mailing Address
First Line	:	10182 INDIANA AVE
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92503-5304
Country	:	US
Telephone Number	:	951-509-2400
Fax Number	:	951-509-2405

Provider Business Practice Location Address
First Line	:	10182 INDIANA AVE
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92503-5304
Country	:	US
Telephone Number	:	951-509-2400
Fax Number	:	951-509-2405

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

Provider Enumeration Date	:	03/10/2015
Last Update Date	:	04/06/2026

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Directions to “ CALEB BROWN ” Practice Location

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