Provider Demographics
NPI:1871554592
Name:BROWNSBERGER, RICHARD N (PA)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:N
Last Name:BROWNSBERGER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 462750
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92046-2750
Mailing Address - Country:US
Mailing Address - Phone:760-520-8500
Mailing Address - Fax:760-520-8523
Practice Address - Street 1:488 E VALLEY PKWY
Practice Address - Street 2:SUITE 404
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3363
Practice Address - Country:US
Practice Address - Phone:760-739-7666
Practice Address - Fax:760-739-7633
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA18269363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA18269Medicaid
Q66397Medicare UPIN
CAWPA18269EMedicare PIN
CAWPA18269AMedicare PIN
CAPA18269Medicaid
CAWPA18269CMedicare PIN
CAWPA18269BMedicare PIN