Provider Demographics
NPI:1063514578
Name:NOVITS, CHRISTOPHER STEPHEN (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:STEPHEN
Last Name:NOVITS
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1222 PRINCETON ST
Mailing Address - Street 2:UNIT 18
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1449
Mailing Address - Country:US
Mailing Address - Phone:310-525-4882
Mailing Address - Fax:
Practice Address - Street 1:1222 PRINCETON ST
Practice Address - Street 2:UNIT 18
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1449
Practice Address - Country:US
Practice Address - Phone:310-525-4882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA18494363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical