Healthcare Provider Details

I. General information

NPI: 1376834572
Provider Name (Legal Business Name): CHRISTOPHER EDWARD URBAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2011
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11939 RANCHO BERNARDO RD STE 115
SAN DIEGO CA
92128-2073
US

IV. Provider business mailing address

11939 RANCHO BERNARDO RD STE 115
SAN DIEGO CA
92128-2073
US

V. Phone/Fax

Practice location:
  • Phone: 858-705-6130
  • Fax: 858-400-4080
Mailing address:
  • Phone: 858-705-6130
  • Fax: 858-400-4080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA144223
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberA144223
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: