Healthcare Provider Details

I. General information

NPI: 1740106590
Provider Name (Legal Business Name): MR. JULIAN CHRISTIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 A ST APT 2103
SAN DIEGO CA
92101-4323
US

IV. Provider business mailing address

310 A ST APT 2103
SAN DIEGO CA
92101-4323
US

V. Phone/Fax

Practice location:
  • Phone: 917-593-6942
  • Fax:
Mailing address:
  • Phone: 917-593-6942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number10674
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: