Provider Demographics
NPI:1417427022
Name:AMARAL, CHRISTOPHER BRYAN
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRYAN
Last Name:AMARAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 T ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-7324
Mailing Address - Country:US
Mailing Address - Phone:916-716-6017
Mailing Address - Fax:
Practice Address - Street 1:1501 CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-5005
Practice Address - Country:US
Practice Address - Phone:916-345-7513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50893183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist