Provider Demographics
NPI:1548457807
Name:JOSEPH-BROWN, DENISE PAULINE (MD)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:PAULINE
Last Name:JOSEPH-BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5122 KATELLA AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-6836
Mailing Address - Country:US
Mailing Address - Phone:562-430-2103
Mailing Address - Fax:562-430-2183
Practice Address - Street 1:5122 KATELLA AVE STE 220
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-6836
Practice Address - Country:US
Practice Address - Phone:562-430-2103
Practice Address - Fax:562-430-2183
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG66679208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC89292Medicare UPIN