Provider Demographics
NPI:1811059918
Name:KRPAN, CHRISTOPHER JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:KRPAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7096
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267-0096
Mailing Address - Country:US
Mailing Address - Phone:209-956-7725
Mailing Address - Fax:209-956-7733
Practice Address - Street 1:1300 KURT DR
Practice Address - Street 2:SUITE 105A
Practice Address - City:ANGELS CAMP
Practice Address - State:CA
Practice Address - Zip Code:95222-9324
Practice Address - Country:US
Practice Address - Phone:209-736-1147
Practice Address - Fax:209-736-8094
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7650207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX76500Medicaid
CAZZZ29860ZMedicare PIN
CA5209930001Medicare PIN
CA00AX76500Medicaid
CA020A76500Medicare PIN
CAH36655Medicare UPIN