Martell Brown

Individual provider Active NPI Community/Behavioral Health Agency · Rosemead, CA

NPI 1508512377 · NPPES record last updated Mar 1, 2022

Key facts

NPI
1508512377
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
42170 (CA)
Practice address
4619 Rosemead Blvd
Rosemead, CA 91770-1478
Phone
(626) 286-1191
NPI assigned
Mar 1, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
42170CAMDCommunity/Behavioral Health Agency

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 42170 CA Yes

Addresses

Primary practice location

4619 Rosemead Blvd
Rosemead, CA 91770-1478

Mailing address

4619 Rosemead Blvd
Rosemead, CA 91770-1478
Phone (626) 286-1191

Other identifiers

IdentifierTypeStateIssuer
42170OtherCAN/A

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL bhc.alhambra@yahoo.com Direct

Other providers in Rosemead, CA

All providers in Rosemead, CA · Community/Behavioral Health Agency in California

Sources for this page

Verify at the official NPI Registry.