Provider Demographics
NPI:1366429045
Name:PAGE, CHRISTOPHER D (DPM)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:D
Last Name:PAGE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:370 DEL NORTE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991
Mailing Address - Country:US
Mailing Address - Phone:530-671-2650
Mailing Address - Fax:530-671-4265
Practice Address - Street 1:370 DEL NORTE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4142
Practice Address - Country:US
Practice Address - Phone:530-671-2650
Practice Address - Fax:530-671-4265
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE4420213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0002390Medicaid
CAZZZ85361ZMedicare ID - Type Unspecified
CAGR0002390Medicaid