Healthcare Provider Details

I. General information

NPI: 1164989224
Provider Name (Legal Business Name): CHRISTOPHER MCNAMARA M.D. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 04/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 N KEYSTONE ST STE B
BURBANK CA
91506-1900
US

IV. Provider business mailing address

640 N KEYSTONE ST STE B
BURBANK CA
91506-1900
US

V. Phone/Fax

Practice location:
  • Phone: 310-272-5556
  • Fax:
Mailing address:
  • Phone: 310-272-5556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER MCNAMARA
Title or Position: CEO, CFO, DIRECTOR, SECRETARY, PRES
Credential: MD
Phone: 310-272-5556