Provider Demographics
NPI:1124058169
Name:PURMER, CHRISTOPHER MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:PURMER
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 1:1000 NEWBURY RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-6435
Mailing Address - Country:US
Mailing Address - Phone:805-480-2600
Mailing Address - Fax:805-480-2677
Practice Address - Street 1:1000 NEWBURY RD
Practice Address - Street 2:SUITE 180
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-6435
Practice Address - Country:US
Practice Address - Phone:805-480-2600
Practice Address - Fax:805-480-2677
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74571207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WG74571EMedicare ID - Type Unspecified
WG74571CMedicare ID - Type Unspecified
G3372Medicare UPIN