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General NPI Number Information
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NPI Number | 1942448261
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Entity Type | Individual
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Provider Name | CHRISTIAN MICHAEL MCNEILL PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/23/2009
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Last Update Date | 06/11/2009
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Provider Practice Location Address
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Address Line | 3555 CESAR CHAVEZ
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-4403
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Country | US
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Telephone | 415-600-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 459 MCAULEY ST
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City | OAKLAND
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State | CA
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Zip | 94609-1546
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Country | US
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Telephone | 415-407-1250
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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 | PA20194
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License Number State | CA
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