Healthcare Provider Details

I. General information

NPI: 1972244010
Provider Name (Legal Business Name): CHRISTOPHER FRIEDRICH BLAINE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST STE 3700
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

4860 Y ST STE 3700
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-3588
  • Fax:
Mailing address:
  • Phone: 916-734-3588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA188892
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: