Provider Demographics
NPI:1093038168
Name:CHRISTOPHER M WRIGHT OD
Entity type:Organization
Organization Name:CHRISTOPHER M WRIGHT OD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:760-352-4361
Mailing Address - Street 1:534 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-3214
Mailing Address - Country:US
Mailing Address - Phone:760-352-4361
Mailing Address - Fax:760-352-2899
Practice Address - Street 1:534 S 8TH ST
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-3214
Practice Address - Country:US
Practice Address - Phone:760-352-4361
Practice Address - Fax:760-352-2899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9558T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0095581Medicaid
CASD0095581Medicaid
CAU02822Medicare UPIN