Provider Demographics
NPI:1144197245
Name:BROWN, ELISE ROSE
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:ROSE
Last Name:BROWN
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13504 ORANGE BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2952
Mailing Address - Country:US
Mailing Address - Phone:760-484-8907
Mailing Address - Fax:
Practice Address - Street 1:12648 POWAY RD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-4416
Practice Address - Country:US
Practice Address - Phone:760-484-8907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist