Basic Information
| Provider Information | |||||||||
| NPI: | 1063918506 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROPHY | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1164 25TH AVE | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958221826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5414803675 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4860 Y ST STE 2700 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958172307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167347463 | ||||||||
| FaxNumber: | 9167346493 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2018 | ||||||||
| LastUpdateDate: | 07/21/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | A159364 | CA | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2081P2900X | A159364 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine |
No ID Information.