MEDICARE: CHRISTINE C BRIONES M.D.

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	208D00000X	General Practice Physician	49886	AZ
2	207V00000X	Obstetrics & Gynecology Physician	38445	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	49886	OTHER	AZ	AZ LICENSE NUMBER

General Provider Information

NPI Number	:	1447275292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE C BRIONES M.D.

Provider Business Mailing Address
First Line	:	1533 E WILLETTA ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2935
Country	:	US
Telephone Number	:	602-715-2840
Fax Number	:	602-569-3887

Provider Business Practice Location Address
First Line	:	15235 N DYSART RD
Second Line	:
City	:	EL MIRAGE
State	:	AZ
Zip	:	85335
Country	:	US
Telephone Number	:	602-569-3999
Fax Number	:

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	10/22/2019

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Directions to “ CHRISTINE C BRIONES M.D.” Practice Location

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