Healthcare Provider Details
I. General information
NPI: 1093778326
Provider Name (Legal Business Name): CHRISTOPHER JAMES ENGELMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/08/2006
Last Update Date: 09/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
431 MONTEREY AVE SUITE 3
LOS GATOS CA
95030-5319
US
IV. Provider business mailing address
10300 S DE ANZA BLVD SUITE A
CUPERTINO CA
95014-3030
US
V. Phone/Fax
- Phone: 408-354-9510
- Fax: 408-395-1610
- Phone: 408-252-7100
- Fax: 408-257-8355
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | A69913 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: