Healthcare Provider Details

I. General information

NPI: 1073199238
Provider Name (Legal Business Name): CHRISTOPHER BEAR TESTA CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2021
Last Update Date: 12/12/2023
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 EAST BLVD
CLEVELAND OH
44106
US

IV. Provider business mailing address

10710 EAST BLVD
CLEVELAND OH
44106
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-3800
  • Fax:
Mailing address:
  • Phone: 216-791-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberLPO.00361
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberLPO.00361
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: