Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | PT23614 | CA |
NPI | 1477599132 |
---|---|
Provider Name | Christina R Brown |
First Address | Huntington Beach, CA 92646-5523 |
Second Address | Huntington Beach, CA 92646-5523 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 01/06/2011 |