Provider Demographics
NPI:1316126758
Name:ESTRADA, CHRISTINE MARIE (DO, MPH)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:MARIE
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3043 PASEO MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3039
Mailing Address - Country:US
Mailing Address - Phone:702-803-0466
Mailing Address - Fax:
Practice Address - Street 1:6330 S JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-3302
Practice Address - Country:US
Practice Address - Phone:702-659-9090
Practice Address - Fax:866-879-7229
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO1969207Q00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPENDINGMedicaid
NVPENDINGMedicare PIN