Provider Demographics
NPI:1699112748
Name:REMIGIO, CHRISTIE MAE TAN (FNP-C)
Entity type:Individual
Prefix:
First Name:CHRISTIE MAE
Middle Name:TAN
Last Name:REMIGIO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 S EL CAMINO REAL
Mailing Address - Street 2:SUITE 101-A
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6248
Mailing Address - Country:US
Mailing Address - Phone:760-685-6599
Mailing Address - Fax:
Practice Address - Street 1:9995 CARMEL MOUNTAIN RD STE B10-11
Practice Address - Street 2:OPERATION SAMAHAN, INC
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-2889
Practice Address - Country:US
Practice Address - Phone:844-200-2426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily