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NPI Code Detail

MEDICARE: MR. CHRIS B THREATT MD

MEDICARE:  MR. CHRIS B THREATT  MD
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
1208800000XUrology PhysicianA79072CA

General Provider Information

NPI Number : 1568466589
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHRIS B THREATT MD
Provider Business Mailing Address
First Line : 570 EL CAMINO REAL # 150-446
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-1200
Country : US
Telephone Number : 650-465-6038
Fax Number : 650-362-9440
Provider Business Practice Location Address
First Line : 801 BREWSTER AVE STE 240
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-1558
Country : US
Telephone Number : 650-465-6038
Fax Number : 650-362-9440
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 09/14/2023

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Directions to “ MR. CHRIS B THREATT MD” Practice Location

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