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General NPI Number Information
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NPI Number | 1588722573
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Entity Type | Individual
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Provider Name | CHRISTOPHER MARK HYNUM M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3100 WRIGHT RD
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City | CAMARILLO
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State | CA
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Zip | 93010-8307
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Country | US
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Telephone | 805-485-7951
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Fax |
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Provider Business Mailing Address
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Address Line | 877 BALLINA CT
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City | NEWBURY PARK
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State | CA
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Zip | 91320-3610
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Country | US
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Telephone | 805-499-0627
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G56085
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License Number State | CA
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