Provider Demographics
NPI:1992734701
Name:TRAUGHBER, CHRISTOPHER W (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:W
Last Name:TRAUGHBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6009
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90734-6009
Mailing Address - Country:US
Mailing Address - Phone:310-938-4961
Mailing Address - Fax:310-534-5591
Practice Address - Street 1:25210 CRENSHAW BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6134
Practice Address - Country:US
Practice Address - Phone:310-938-4961
Practice Address - Fax:310-534-5590
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG42264207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA48888Medicare UPIN
CAWG42264AMedicare ID - Type Unspecified