Individual provider Active NPI

Ezequiel M Brown, MD

  • Psychiatry Physician
  • Long Beach, CA
National Provider Identifier
1619401312
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A159361 Issued in CA
Practice address
2600 Redondo Ave FL 3
Long Beach, CA 90806-2325
Phone
(562) 256-2900
NPI assigned
Apr 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A159361 CA Primary

Addresses

Primary practice location

2600 Redondo Ave FL 3
Long Beach, CA 90806-2325

Mailing address

2600 Redondo Ave FL 3
Long Beach, CA 90806-2325
Phone (562) 256-2900

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190311002014 CA Practitioner - Psychiatry 9739428665 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Iowa, RJ & L Carver College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2600 Redondo Ave
FL 3
Long Beach, CA 90806-2325
Phone (562) 256-2900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A159361CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jul 26, 2021 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients
County of Los Angeles Auditor Controller CurrentSince Mar 1, 2019 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Jul 26, 2021 Accepting new patients
County of Los Angeles CurrentSince Mar 1, 2019 Accepting new patients

Locations

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

14445 Olive View Dr
#1
Sylmar, CA 91342

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1619401312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 REDONDO AVE FL 3",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062325",
            "telephone_number": "562-256-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 REDONDO AVE FL 3",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062325",
            "telephone_number": "562-256-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "EZEQUIEL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-19",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A159361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.