Healthcare Provider Details

I. General information

NPI: 1467570697
Provider Name (Legal Business Name): MR. CHRISTOPHER ERNEST MAYER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13081 CENTRAL AVE
BOULDER CREEK CA
95006
US

IV. Provider business mailing address

576 PALISADES AVE
SANTA CRUZ CA
95062
US

V. Phone/Fax

Practice location:
  • Phone: 831-338-2144
  • Fax: 831-338-0901
Mailing address:
  • Phone: 831-338-2144
  • Fax: 831-338-0901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH32350
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: