Healthcare Provider Details

I. General information

NPI: 1346943396
Provider Name (Legal Business Name): CHRISTINA NAKHOUL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4212 MISSOURI FLAT RD
PLACERVILLE CA
95667-6269
US

IV. Provider business mailing address

4212 MISSOURI FLAT RD # 95667
PLACERVILLE CA
95667-6269
US

V. Phone/Fax

Practice location:
  • Phone: 530-621-7700
  • Fax: 153-062-1771
Mailing address:
  • Phone:
  • Fax: 153-062-1771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number212113
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: