Brown, Blaine

Brown, Blaine is an individual health care provider with primary practice located at 2101 N Waterman Ave , San Bernardino CA 92404-4836. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Brown, Blaine can be contacted via phone (909) 883-8711.

Contact Information

Primary practice address
2101 N Waterman Ave San Bernardino CA 92404-4836
Phone: (909) 883-8711
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 179635-1205 Utah
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X A96642 California

Profile Details

NPI number 1689692774
LBN Legal business name Brown, Blaine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Mar 11th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689692774 NPPES
Other P00611233 RR
MEDICAID 00A966420 RR

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