Basic Information
| Provider Information | |||||||||
| NPI: | 1295872752 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PILCHER | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 518 PIXIE TRL | ||||||||
| Address2: | |||||||||
| City: | MILL VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 949413371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152594609 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 995 POTRERO AVE | ||||||||
| Address2: | WARD 84, BUILDING 80 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941102859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154764082 | ||||||||
| FaxNumber: | 4154766953 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | G87937 | CA | Y | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | G87937 | 01 | CA | CALIFORNIA MEDICAL LIC | OTHER | BP7989481 | 01 | DEA NUMBER | OTHER |