MEDICARE: BROWN PHYSICAL THERAPY INC

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1922371335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROWN PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	5851 LANCEFIELD DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-4904
Country	:	US
Telephone Number	:	760-218-1400
Fax Number	:	714-840-3694

Provider Business Practice Location Address
First Line	:	13071 BROOKHURST ST
Second Line	:	SUITE 110
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-1091
Country	:	US
Telephone Number	:	714-636-7410
Fax Number	:	714-636-6874

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JAMES W BROWN
Credential	:	P.T.
Telephone Number	:	714-636-7410

Provider Enumeration Date	:	02/15/2012
Last Update Date	:	04/04/2014

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