Individual provider Active NPI

Jerry Lamont Brown, PHYSICIAN ASSISTANT

  • Surgical Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1497895049
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1037115 Issued in CA
Practice address
12021 Wilmington Ave
Los Angeles, CA 90059-3019
Phone
(310) 668-4287
NPI assigned
Feb 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1037115 CA Primary

Addresses

Primary practice location

12021 Wilmington Ave
Los Angeles, CA 90059-3019

Mailing address

14103 S Evers Ave
Compton, CA 90222-3707
Phone (310) 863-6692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090825000698 CA Practitioner - Physician Assistant 7012062128 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1037115CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince May 8, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 5, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 5, 2020 Accepting new patients
University of California San Francisco CurrentSince May 8, 2019 Accepting new patients
Regents of the University of California CurrentSince May 8, 2019 Accepting new patients
American Current Care of California, a Medical Corporation CurrentSince Aug 2, 2021 Accepting new patients
American Current Care of California, a Medical Corporation CurrentSince Aug 2, 2021 Accepting new patients
County of Los Angeles Past Accepting new patients

Locations

1800 Westwind Dr
Ste 301
Bakersfield, CA 93301
Phone (661) 327-9617

15302 El Prado Rd
Chino, CA 91710
Phone (909) 393-7222

2499 S Wilmington Ave
Compton, CA 90220
Phone (310) 638-1113

2555 S East Ave
Fresno, CA 93706
Phone (559) 499-2400

6033 W Century Blvd
Ste 200
Los Angeles, CA 90045
Phone (310) 215-1600

1340 Mitchell Rd
Modesto, CA 95351
Phone (209) 581-9711

25115 Madison Ave
Murrieta, CA 92562
Phone (951) 600-9070

1101 S Milliken Ave
Ste C
Ontario, CA 91761
Phone (909) 390-2799

1851 Lombard St
Ste 100
Oxnard, CA 93030
Phone (805) 983-2234

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

640 S Placentia Ave
Placentia, CA 92870
Phone (714) 579-7772

2 Connecticut St
San Francisco, CA 94107
Phone (415) 621-5055

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

2587 Merced St
San Leandro, CA 94577
Phone (510) 351-3553

740 Nordahl Rd
Ste 131
San Marcos, CA 92069
Phone (760) 432-9000

800 N Tustin Ave
Ste A
Santa Ana, CA 92705
Phone (714) 245-0800

988 Walsh Ave
Santa Clara, CA 95050
Phone (408) 988-6868

1221 N Dutton Ave
Santa Rosa, CA 95401
Phone (707) 543-8360

3 S Linden Ave
South San Francisco, CA 94080
Phone (650) 238-1500

3663 Arch Rd
Ste 400
Stockton, CA 95215
Phone (209) 943-2202

21081 S Western Ave
Ste 150
Torrance, CA 90501
Phone (310) 782-3333

3680 Industrial Blvd
Ste 550H
West Sacramento, CA 95691
Phone (916) 373-7575

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497895049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14103 S EVERS AVE",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902223707",
            "telephone_number": "310-863-6692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 WILMINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593019",
            "telephone_number": "310-668-4287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JERRY",
        "middle_name": "LAMONT",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "1037115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.