=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386405819
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHRISTOPHER STALBERG MD CONSULTING PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2024
-----------------------------------------------------
Last Update Date | 01/22/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4646 E DESERT PARK PL
-----------------------------------------------------
City | PARADISE VALLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85253-2911
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-399-7420
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4646 E DESERT PARK PL
-----------------------------------------------------
City | PARADISE VALLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85253-2911
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-399-7420
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER
-----------------------------------------------------
Name | DR. CHRISTOPHER STALBERG
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 480-399-7420
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------