Provider Demographics
NPI:1669474235
Name:RANK, CHRISTIAN LEE (MD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:LEE
Last Name:RANK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 WASHINGTON ST
Mailing Address - Street 2:STE 150-8881
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103
Mailing Address - Country:US
Mailing Address - Phone:949-799-8025
Mailing Address - Fax:949-481-6666
Practice Address - Street 1:27529 PUERTA REAL
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6321
Practice Address - Country:US
Practice Address - Phone:949-481-8881
Practice Address - Fax:949-481-6666
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA73486202D00000X, 207P00000X, 208D00000X
NV10935202D00000X, 208D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100504302Medicaid
CA00A734860Medicaid
NV100072Medicare ID - Type UnspecifiedNORIDIAN
CA00A734860Medicaid
CAWA73486DMedicare PIN
NV100504302Medicaid