Healthcare Provider Details

I. General information

NPI: 1235205543
Provider Name (Legal Business Name): CHRISTINA T WADE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 VERDUGO RD VERDUGO HILLS HOSPITAL
GLENDALE CA
91208
US

IV. Provider business mailing address

PO BOX 1036
MONTROSE CA
91021
US

V. Phone/Fax

Practice location:
  • Phone: 818-790-7100
  • Fax:
Mailing address:
  • Phone: 818-248-9843
  • Fax: 818-248-9884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberG17056
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberG17056
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberG17056
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberG17056
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberG17056
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG17056
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License NumberG17056
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberG17056
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code2085R0205X
TaxonomyRadiological Physics Physician
License NumberG17056
License Number StateCA
# 10
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberG17056
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: