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General NPI Number Information
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NPI Number | 1780147694
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Entity Type | Individual
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Provider Name | RHOBE BRAGER DO
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Gender | Female
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Dates
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Enumeration Date | 04/08/2019
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Last Update Date | 08/08/2022
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Provider Practice Location Address
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Address Line | 2071 HERNDON AVE
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City | CLOVIS
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State | CA
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Zip | 93611-6101
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Country | US
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Telephone | 209-406-5752
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2434
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City | CLOVIS
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State | CA
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Zip | 93613-2434
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Country | US
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Telephone | 209-406-5752
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 20A19566
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License Number State | CA
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