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NPI Code Detail

MEDICARE: CHRISTOPHER PAUL LONG

MEDICARE:   CHRISTOPHER PAUL LONG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianA196422CA

General Provider Information

NPI Number : 1063098556
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER PAUL LONG
Provider Business Mailing Address
First Line : 30131 TOWN CENTER DR STE 247
Second Line :
City : LAGUNA NIGUEL
State : CA
Zip : 92677-2033
Country : US
Telephone Number : 949-239-1103
Fax Number :
Provider Business Practice Location Address
First Line : 30131 TOWN CENTER DR STE 247
Second Line :
City : LAGUNA NIGUEL
State : CA
Zip : 92677-2033
Country : US
Telephone Number : 949-239-1103
Fax Number : 949-816-1549
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2021
Last Update Date : 05/28/2026

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Directions to “ CHRISTOPHER PAUL LONG ” Practice Location

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