Provider Demographics
NPI:1982701272
Name:BYRNE, CHRISTOPHER M (DPM)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:BYRNE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1551 BISHOP ST STE B210
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-4635
Mailing Address - Country:US
Mailing Address - Phone:805-543-7788
Mailing Address - Fax:805-543-7828
Practice Address - Street 1:1551 BISHOP ST STE B210
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4635
Practice Address - Country:US
Practice Address - Phone:805-543-7788
Practice Address - Fax:805-543-7828
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4236213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE4236OtherSTATE LICENSE
CAU46231Medicare UPIN
CAWE4236CMedicare ID - Type Unspecified