Provider Demographics
NPI:1346326907
Name:GULBRANDSON, CHRISTOPHER (MPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:GULBRANDSON
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:GULBRANDSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT
Mailing Address - Street 1:6526 LONETREE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5886
Mailing Address - Country:US
Mailing Address - Phone:916-772-2909
Mailing Address - Fax:916-772-2989
Practice Address - Street 1:6526 LONETREE BLVD.
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5874
Practice Address - Country:US
Practice Address - Phone:916-772-2909
Practice Address - Fax:916-772-2989
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT280762251S0007X, 2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic