Healthcare Provider Details

I. General information

NPI: 1851451439
Provider Name (Legal Business Name): KRISTOPHER LEE DOWNING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 06/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9834 GENESEE AVE STE 228
LA JOLLA CA
92037-1215
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 858-824-1703
  • Fax: 858-455-6473
Mailing address:
  • Phone: 858-412-6080
  • Fax: 619-421-3557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberA106278
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA106278
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: