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General NPI Number Information
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NPI Number | 1679609507
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Entity Type | Individual
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Provider Name | JOHN B. CHRISTENSEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 09/02/2009
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Provider Practice Location Address
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Address Line | 1555 SOQUEL DR DOMINICAN HOSPITAL EMERGENCY DEPT.
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City | SANTA CRUZ
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State | CA
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Zip | 95065-1705
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Country | US
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Telephone | 831-462-7730
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1190 SANTA CRUZ EMERGENCY PHYSICIANS
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City | CAPITOLA
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State | CA
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Zip | 95010-1190
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Country | US
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Telephone | 831-335-0905
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | G33311
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License Number State | CA
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