MEDICARE: DR. JEFFREY HUGH BROWN O.D.

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	152WC0802X	Corneal and Contact Management Optometrist	8065T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891853917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY HUGH BROWN O.D.

Provider Business Mailing Address
First Line	:	1175 BAKER ST
Second Line	:	E-16
City	:	COSTA MESA
State	:	CA
Zip	:	92626-4101
Country	:	US
Telephone Number	:	714-979-1811
Fax Number	:

Provider Business Practice Location Address
First Line	:	1175 BAKER ST
Second Line	:	E-16
City	:	COSTA MESA
State	:	CA
Zip	:	92626-4101
Country	:	US
Telephone Number	:	714-979-1811
Fax Number	:

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

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	07/14/2011

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