Jerry Lamont Brown, PHYSICIAN ASSISTANT
Individual provider Active NPI Surgical Physician Assistant · Los Angeles, CA
NPI 1497895049 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497895049
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 1037115 (CA)
- Practice address
- 12021 Wilmington Ave
Los Angeles, CA 90059-3019 - Phone
- (310) 668-4287
- NPI assigned
- Feb 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 13
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090825000698 | CA | Practitioner - Physician Assistant | 7012062128 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1037115 | CA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of California San Francisco | Current |
Accepting new patients | |
| American Current Care of California, a Medical Corporation | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| University of California San Francisco | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| American Current Care of California, a Medical Corporation | Current |
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
400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000
2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444
505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058
2 Connecticut St
San Francisco, CA 94107
Phone (415) 621-5055
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 1037115 | CA | Yes |
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
Other providers in Los Angeles, CA
- Javon Brown
- Jenny Lynette Brown
- Jeri - Brown
- Jermal Brown
- Jerome Brown
- Jocelyn Anne Brown
- Jocelyn Elizabeth Brown
- John Wayne Brown
- Johnathan Brown Sr.
- Johnathan Charles Brown
All providers in Los Angeles, CA · Surgical Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.