MEDICARE: DR. JOHN ROGER CHRISTENSEN M.D.

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
1	207R00000X	Internal Medicine Physician	G39869	CA

General Provider Information

NPI Number	:	1689646556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN ROGER CHRISTENSEN M.D.

Provider Business Mailing Address
First Line	:	10700 MACARTHUR BLVD
Second Line	:	STE 14 B
City	:	OAKLAND
State	:	CA
Zip	:	94605-5298
Country	:	US
Telephone Number	:	510-563-4300
Fax Number	:	510-563-4381

Provider Business Practice Location Address
First Line	:	10700 MACARTHUR BLVD
Second Line	:	STE 14 B
City	:	OAKLAND
State	:	CA
Zip	:	94605-5298
Country	:	US
Telephone Number	:	510-563-4300
Fax Number	:	510-563-4381

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	01/05/2012

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