Healthcare Provider Details

I. General information

NPI: 1073345781
Provider Name (Legal Business Name): MR. CHRISTOPHER BRENNAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NSA GSK BANZ WAREHOUSE BAY 6
MANAMA BAHRAIN
09501
BH

IV. Provider business mailing address

NSA GSK BANZ WAREHOUSE BAY 6
MANAMA BAHRAIN
09501
BH

V. Phone/Fax

Practice location:
  • Phone: 559-240-8735
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: