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General NPI Number Information
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NPI Number | 1215730056
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Entity Type | Individual
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Provider Name | CHRISTOPHER A FONTAYNE
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Gender | Male
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Dates
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Enumeration Date | 03/28/2025
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 955 E THOMPSON BLVD
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City | VENTURA
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State | CA
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Zip | 93001-3008
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Country | US
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Telephone | 805-641-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 2640 WAGON WHEEL RD APT 258
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City | OXNARD
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State | CA
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Zip | 93036-2137
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Country | US
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Telephone | 240-886-4537
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LA0401X
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Taxonomy Name | Addiction Medicine (Anesthesiology) Physician
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License Number | 56-08
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License Number State | CA
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