Provider Demographics
NPI:1225011414
Name:BROPHY, GWENDOLYN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:GWENDOLYN
Middle Name:MARIE
Last Name:BROPHY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:BOX 555191
Mailing Address - Street 2:NAVAL HOSPITAL CAMP PENDLETON
Mailing Address - City:CAMP PENDLETON
Mailing Address - State:CA
Mailing Address - Zip Code:92055-5191
Mailing Address - Country:US
Mailing Address - Phone:760-725-1066
Mailing Address - Fax:760-725-1690
Practice Address - Street 1:BUILDING H-100, 555191
Practice Address - Street 2:NAVAL HOSPITAL CAMP PENDLETON
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055-5191
Practice Address - Country:US
Practice Address - Phone:760-725-1066
Practice Address - Fax:760-725-1690
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2012-09-28
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Provider Licenses
StateLicense IDTaxonomies
CAA1062072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology