Steven G Brown, MS PT
Individual provider
Active NPI
Specialist · Chester, CA
NPI 1124121413 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124121413
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- S80185 (CA)
- Practice address
- 130 Brentwood Dr
Chester, CA 96020
- Phone
- (530) 258-1986
- NPI assigned
- Sep 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| I20230829001474 |
CA |
Practitioner - Physical Therapist in Private Practice |
5496118101 |
Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|
| S80185 | CA | MD | Specialist |
Practice roles
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Specialist |
174400000X |
S80185 |
CA |
Yes |
Addresses
Primary practice location
130 Brentwood Dr
Chester, CA 96020
Mailing address
130 Brentwood Dr
Chester, CA 96020
Phone (530) 258-1986
Other identifiers
| Identifier | Type | State | Issuer |
|---|
| OOPT18494 | Medicaid | CA | |