Provider Demographics
NPI:1538272257
Name:BROWN, RONALD L (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:L
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:855-771-0335
Mailing Address - Fax:
Practice Address - Street 1:2030 SUTTER PL
Practice Address - Street 2:SUITE 1200
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-6212
Practice Address - Country:US
Practice Address - Phone:530-792-2820
Practice Address - Fax:530-792-2828
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG74668207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G746680Medicaid
CA00G746680Medicaid
00G746682Medicare ID - Type Unspecified