Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 15826 | CA |
Y | 111NI0900X | Internist | 15826 | CA |
N | 111NX0100X | Occupational Health | 15826 | CA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 15826 | CA |
NPI | 1821098336 |
---|---|
Provider Name | Donald Richard Brophy III |
First Address | Antioch, CA 94509-6127 |
Second Address | Antioch, CA 94509-6127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 08/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC0158260 | (05) | CA |
T76484 | HILL PHYSICIANS (01) | CA |