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NPI Code Detail

MEDICARE: CHRISTOPHER MADDEN

MEDICARE: CHRISTOPHER MADDEN
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
1225200000XPhysical Therapy AssistantAT3940CA

General Provider Information

NPI Number : 1891183612
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER MADDEN
Provider Business Mailing Address
First Line : 1812 DEVONSHIRE RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95864-1505
Country : US
Telephone Number : 916-342-5488
Fax Number :
Provider Business Practice Location Address
First Line : 3400 ALTA ARDEN EXPY
Second Line :
City : SACRAMENTO
State : CA
Zip : 95825-2103
Country : US
Telephone Number : 916-481-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2014
Last Update Date : 12/31/2014

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