Provider Demographics
NPI:1104936129
Name:SMALE, CHRISTOPHER L (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:L
Last Name:SMALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1004 ACACIA AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-1204
Mailing Address - Country:US
Mailing Address - Phone:661-872-8131
Mailing Address - Fax:661-872-0450
Practice Address - Street 1:4000 PHYSICIANS BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5839
Practice Address - Country:US
Practice Address - Phone:661-327-4885
Practice Address - Fax:661-327-1430
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2014-09-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG21573207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA942078779OtherTAX ID
CAG21573OtherCALIFORNIA LICENSE
CAG21573OtherCALIFORNIA LICENSE