Healthcare Provider Details

I. General information

NPI: 1437409083
Provider Name (Legal Business Name): CHRISTOPHER ANDREW PARKER CRT, RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2012
Last Update Date: 05/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 GOVERNOR DR
SAN DIEGO CA
92122-2901
US

IV. Provider business mailing address

690 OTAY LAKES RD SUITE 200
CHULA VISTA CA
91910-8904
US

V. Phone/Fax

Practice location:
  • Phone: 619-274-3578
  • Fax:
Mailing address:
  • Phone: 619-274-3578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number27927
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number27927
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: