Provider Demographics
NPI:1184245870
Name:BRUMBLEY, DONA PIERANTONI (RT (R) (CT))
Entity type:Individual
Prefix:
First Name:DONA
Middle Name:PIERANTONI
Last Name:BRUMBLEY
Suffix:
Gender:F
Credentials:RT (R) (CT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1836 WOODSAGE WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-7030
Mailing Address - Country:US
Mailing Address - Phone:707-477-4603
Mailing Address - Fax:
Practice Address - Street 1:1701 4TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-3658
Practice Address - Country:US
Practice Address - Phone:707-523-7025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHF000640422085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology