Healthcare Provider Details

I. General information

NPI: 1659698447
Provider Name (Legal Business Name): CHRISTINA KWOK-OLEKSY DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2010
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 SUMMIT ST STE 101
OAKLAND CA
94609-3423
US

IV. Provider business mailing address

2929 SUMMIT ST STE 101
OAKLAND CA
94609-3423
US

V. Phone/Fax

Practice location:
  • Phone: 510-628-8477
  • Fax: 510-628-3645
Mailing address:
  • Phone: 510-628-8477
  • Fax: 510-628-3645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4886
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: