MEDICARE: DONALD RICHARD BROPHY III D.C,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NI0900X	Internist Chiropractor	15826	CA
2	111NX0100X	Occupational Health Chiropractor	15826	CA
3	111NX0800X	Orthopedic Chiropractor	15826	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	T76484	OTHER	CA	HILL PHYSICIANS

General Provider Information

NPI Number	:	1821098336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD RICHARD BROPHY III D.C,

Provider Business Mailing Address
First Line	:	3731 SUNSET LN
Second Line	:	SUITE 102
City	:	ANTIOCH
State	:	CA
Zip	:	94509-6127
Country	:	US
Telephone Number	:	925-754-6780
Fax Number	:	925-754-6915

Provider Business Practice Location Address
First Line	:	3731 SUNSET LN
Second Line	:	SUITE 102
City	:	ANTIOCH
State	:	CA
Zip	:	94509-6127
Country	:	US
Telephone Number	:	925-754-6780
Fax Number	:	925-754-6915

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	08/08/2012

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