Healthcare Provider Details

I. General information

NPI: 1447160015
Provider Name (Legal Business Name): CHRISTIAN HADAP DOLOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 HOSPITAL WAY, MATHER AFB, UNITED STATES, 95655
APO AA
95655
US

IV. Provider business mailing address

9388 RIVER OAKS LN
ORANGEVALE CA
95662-4953
US

V. Phone/Fax

Practice location:
  • Phone: 916-695-3565
  • Fax:
Mailing address:
  • Phone: 831-521-6127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number776920
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: