Provider Demographics
NPI:1194766451
Name:BROWN, CHRISTOPHER JAMES (CRNA)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:BROWN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34521 VIA CATALINA
Mailing Address - Street 2:UNIT 'B'
Mailing Address - City:CAPISTRANO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92624-1215
Mailing Address - Country:US
Mailing Address - Phone:949-489-8694
Mailing Address - Fax:949-489-8694
Practice Address - Street 1:34521 VIA CATALINA
Practice Address - Street 2:UNIT 'B'
Practice Address - City:CAPISTRANO BEACH
Practice Address - State:CA
Practice Address - Zip Code:92624-1215
Practice Address - Country:US
Practice Address - Phone:949-489-8694
Practice Address - Fax:949-489-8694
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANA809367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN2459501Medicaid
NA809Medicare PIN
WNA809BMedicare PIN