Healthcare Provider Details

I. General information

NPI: 1750811501
Provider Name (Legal Business Name): CHRISTOPHER HAMBRE JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2017
Last Update Date: 06/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USS SIROCCO PC 6 UNIT 100287 FPO AE
MANAMA KINGDOM ON BAHRAIN
69287
BH

IV. Provider business mailing address

546 CHELSEA DR
HENDERSON NV
89014-3909
US

V. Phone/Fax

Practice location:
  • Phone: 760-586-6278
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: