Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 20A14193 | CA |
NPI | 1285982975 |
---|---|
Provider Name | Christopher Brown |
First Address | Albany, CA 94706-2120 |
Second Address | Albany, CA 94706-2120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2012 |
Last Update Date | 05/10/2015 |