Provider Demographics
NPI:1679624837
Name:MURPHY, BRIAN (ATC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:MURPHY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7634 CONTINENTAL PL
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4500 RIVERWALK PKWY
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3344
Practice Address - Country:US
Practice Address - Phone:951-785-2534
Practice Address - Fax:951-785-2291
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2008-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer