Healthcare Provider Details

I. General information

NPI: 1932551082
Provider Name (Legal Business Name): CHRISTOPHER KREPS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N EL CAMINO REAL STE 201
ENCINITAS CA
92024-1335
US

IV. Provider business mailing address

4445 EASTGATE MALL STE 105
SAN DIEGO CA
92121-1979
US

V. Phone/Fax

Practice location:
  • Phone: 760-436-8667
  • Fax:
Mailing address:
  • Phone: 858-357-9450
  • Fax: 858-412-6376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5585
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: