Healthcare Provider Details

I. General information

NPI: 1225226228
Provider Name (Legal Business Name): CHRISTOPHER J KRPAN DO PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 10/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 KURT DR SUITE 105
ANGELS CAMP CA
95222-9324
US

IV. Provider business mailing address

PO BOX 7096
STOCKTON CA
95267-0096
US

V. Phone/Fax

Practice location:
  • Phone: 209-736-1147
  • Fax: 209-736-8094
Mailing address:
  • Phone: 209-956-7725
  • Fax: 209-956-7733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number20A7650
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5209930001
License Number StateCA

VIII. Authorized Official

Name: DR. CHRISTOPHER JAMES KRPAN
Title or Position: OWNER
Credential: DO
Phone: 209-736-1147