Provider Demographics
NPI:1558375758
Name:CHRISTOPHER, HEIDI LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:LYNN
Last Name:CHRISTOPHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26560 AGOURA RD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1926
Mailing Address - Country:US
Mailing Address - Phone:818-880-2509
Mailing Address - Fax:818-880-4592
Practice Address - Street 1:26560 AGOURA RD
Practice Address - Street 2:SUITE 113
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1926
Practice Address - Country:US
Practice Address - Phone:818-880-2509
Practice Address - Fax:818-880-4592
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23978111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC23978Medicare ID - Type UnspecifiedMEDICARE NUMBER
CAU63139Medicare UPIN