Basic Information
Provider Information
NPI: 1225332125
EntityType: 2
ReplacementNPI:  
OrganizationName: CHRISTOPHER CARTER MD CORP
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 210 N TUSTIN AVE
Address2:  
City: SANTA ANA
State: CA
PostalCode: 927053807
CountryCode: US
TelephoneNumber: 8008837243
FaxNumber: 7146471245
Practice Location
Address1: 3444 KEARNY VILLA RD STE 100
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921231960
CountryCode: US
TelephoneNumber: 8582683566
FaxNumber: 8582680430
Other Information
ProviderEnumerationDate: 01/06/2011
LastUpdateDate: 03/23/2017
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: CARTER
AuthorizedOfficialFirstName: CHRISTOPHER
AuthorizedOfficialMiddleName: G
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 7143471010
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XG74737CAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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