MEDICARE: CHRISTINE CELESTE BRENNAN MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	A195905	CA

General Provider Information

NPI Number	:	1629657473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE CELESTE BRENNAN MD

Provider Business Mailing Address
First Line	:	1300 N 12TH ST STE 508
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2849
Country	:	US
Telephone Number	:	602-839-3927
Fax Number	:	602-839-3927

Provider Business Practice Location Address
First Line	:	450 BROADWAY ST FL 2
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94063-3132
Country	:	US
Telephone Number	:	507-236-6016
Fax Number	:

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

Provider Enumeration Date	:	04/07/2021
Last Update Date	:	03/11/2026

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