Provider Demographics
NPI:1063569838
Name:SON, CHRISTOPHER (OD PC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:SON
Suffix:
Gender:M
Credentials:OD PC
Other - Prefix:
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Mailing Address - Street 1:8093L TYSONS CORNER CTR
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-4505
Mailing Address - Country:US
Mailing Address - Phone:703-748-1366
Mailing Address - Fax:703-748-1352
Practice Address - Street 1:8093L TYSONS CORNER CTR
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-4505
Practice Address - Country:US
Practice Address - Phone:703-748-1366
Practice Address - Fax:703-748-1352
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0618001121152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU50896Medicare UPIN
VA417616Medicare PIN