Healthcare Provider Details

I. General information

NPI: 1215257092
Provider Name (Legal Business Name): CHRISTOPHER ALAN VERIOTI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 09/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 MALL DR STE 211A
HANFORD CA
93230-5794
US

IV. Provider business mailing address

125 MALL DR STE 211A
HANFORD CA
93230-5794
US

V. Phone/Fax

Practice location:
  • Phone: 559-537-0330
  • Fax: 559-537-0332
Mailing address:
  • Phone: 559-537-0330
  • Fax: 559-537-0332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number20A13329
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: