Healthcare Provider Details

I. General information

NPI: 1831716307
Provider Name (Legal Business Name): CHRISTOPHER ROBERT RAY HYDE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2020
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE. BLDG. 5, 1ST FL.
SAN FRANCISCO CA
94110
US

IV. Provider business mailing address

513 PARNASSUS AVE
SAN FRANCISCO CA
94143-2205
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-8020
  • Fax:
Mailing address:
  • Phone: 415-624-5097
  • Fax: 805-569-8358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA189609
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: