Doctor Name: | MATTHEW BROWN |
NPI Number: | 1023464864 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | IMF #90645 |
License Number: | RII2880115 |
Business Practice Address: | 1664 Broadway El Cajon, CA - 920215201 |
Business Phone Number: | 6195798685 |
Business Fax Number: | 6195791969 |
Mailing Address: | 1664 Broadway, EL CAJON |
State: | CA |
Postal Code: | 920215201 |
Phone Number: | 6195798685 |
Fax Number: | 6195791969 |
NPI Enumeration Date: | 05/11/2016 |
NPI Last Update Date: | 05/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | RII2880115 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |