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General NPI Number Information
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NPI Number | 1316782378
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Entity Type | Individual
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Provider Name | CHRISTOPHER BEUDER
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Gender | Male
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Dates
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Enumeration Date | 07/01/2024
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 323 N PRAIRIE AVE STE 320
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City | INGLEWOOD
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State | CA
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Zip | 90301-4505
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Country | US
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Telephone | 424-480-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 1121 5TH ST
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-6003
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Country | US
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Telephone | 310-880-7348
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA66723
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License Number State | CA
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