Provider Demographics
NPI:1306867460
Name:HOLDEN, CHRISTOPHER (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:HOLDEN
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 1:438 E KATELLA AVE
Mailing Address - Street 2:STE B
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-4839
Mailing Address - Country:US
Mailing Address - Phone:714-744-5000
Mailing Address - Fax:714-744-5985
Practice Address - Street 1:438 E KATELLA AVE
Practice Address - Street 2:STE B
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-4839
Practice Address - Country:US
Practice Address - Phone:714-744-5000
Practice Address - Fax:714-744-5985
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75635207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF73589Medicare UPIN
CAG75635Medicare ID - Type UnspecifiedPROVIDER NUMBER