Provider Demographics
NPI:1417447327
Name:DIXON, CHRISTINA THERESA (MD)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:THERESA
Last Name:DIXON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:THERESA
Other - Last Name:DOHERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:513 PARNASSUS AVE # S455E
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2205
Mailing Address - Country:US
Mailing Address - Phone:415-514-3781
Mailing Address - Fax:415-514-0185
Practice Address - Street 1:513 PARNASSUS AVE # S455E
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2205
Practice Address - Country:US
Practice Address - Phone:415-514-3781
Practice Address - Fax:415-514-0185
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA167196207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology