Healthcare Provider Details
I. General information
NPI: 1922118884
Provider Name (Legal Business Name): CHRISTOPHER KINTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 11/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
729 N MEDICAL CENTER DR W STE 111
CLOVIS CA
93611-6880
US
IV. Provider business mailing address
2625 E DIVISADERO ST
FRESNO CA
93721-1431
US
V. Phone/Fax
- Phone: 559-435-6600
- Fax: 559-435-6622
- Phone: 559-443-2682
- Fax: 559-443-2681
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | G73863 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | G73863 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: