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General NPI Number Information
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NPI Number | 1245478098
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Entity Type | Individual
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Provider Name | CONRAD DEAN COLBRANDT C.HT.
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Gender | Male
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 02/02/2009
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Provider Practice Location Address
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Address Line | 2430 WALNUT BLVD
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City | WALNUT CREEK
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State | CA
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Zip | 94597-3835
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Country | US
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Telephone | 925-465-4978
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Fax | 925-465-4672
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Provider Business Mailing Address
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Address Line | 1630 N MAIN ST # 320
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City | WALNUT CREEK
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State | CA
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Zip | 94596-4609
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Country | US
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Telephone | 925-465-4978
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Fax | 925-465-4672
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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