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NPI Code Detail

MEDICARE: DR. CHRISTOPHER PUDOL D.O.

MEDICARE: DR. CHRISTOPHER PUDOL D.O.
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 PhysicianOS8199FL
2207Q00000XFamily Medicine Physician20A14907CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851386080
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER PUDOL D.O.
Provider Business Mailing Address
First Line : 1000 VALE TERRACE DR
Second Line :
City : VISTA
State : CA
Zip : 92084-5218
Country : US
Telephone Number : 760-631-5000
Fax Number :
Provider Business Practice Location Address
First Line : 1000 VALE TERRACE DR
Second Line :
City : VISTA
State : CA
Zip : 92084-5218
Country : US
Telephone Number : 760-631-5000
Fax Number : 760-414-3892
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2005
Last Update Date : 10/05/2016

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Directions to “ DR. CHRISTOPHER PUDOL D.O.” Practice Location

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