Healthcare Provider Details

I. General information

NPI: 1275452773
Provider Name (Legal Business Name): CHRISTOPHER PITKIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CHIP PITKIN

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7917 OSTROW ST STE A
SAN DIEGO CA
92111-3604
US

IV. Provider business mailing address

1202 MORENA BLVD STE 100
SAN DIEGO CA
92110-3842
US

V. Phone/Fax

Practice location:
  • Phone: 858-300-8282
  • Fax:
Mailing address:
  • Phone: 619-275-0822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: