Healthcare Provider Details

I. General information

NPI: 1801071592
Provider Name (Legal Business Name): CHRISTOPHER BROWN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2008
Last Update Date: 12/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34521 VIA CATALINA UNIT B
CAPISTRANO BEACH CA
92624-1215
US

IV. Provider business mailing address

34521 VIA CATALINA UNIT B
CAPISTRANO BEACH CA
92624-1215
US

V. Phone/Fax

Practice location:
  • Phone: 714-322-0055
  • Fax:
Mailing address:
  • Phone: 714-322-0055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberNA 809
License Number StateCA

VIII. Authorized Official

Name: CHRISTOPHER JAMES BROWN
Title or Position: PRESIDENTOWNER
Credential: CRNA
Phone: 714-322-0055