Provider Demographics
NPI:1063741056
Name:CONDERMAN, CHRISTIAN PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:PATRICK
Last Name:CONDERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 MORAGA WAY STE G
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-3019
Mailing Address - Country:US
Mailing Address - Phone:925-254-6710
Mailing Address - Fax:
Practice Address - Street 1:77 MORAGA WAY STE G
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-3019
Practice Address - Country:US
Practice Address - Phone:925-254-6710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-21
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115187207YS0123X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery