Provider Demographics
NPI:1477599132
Name:BROWN, CHRISTINA R (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:R
Last Name:BROWN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20712 FARNSWORTH LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-5523
Mailing Address - Country:US
Mailing Address - Phone:714-323-0166
Mailing Address - Fax:
Practice Address - Street 1:20712 FARNSWORTH LN
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-5523
Practice Address - Country:US
Practice Address - Phone:714-323-0166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT23614204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT23614AMedicare ID - Type Unspecified