Basic Information
| Provider Information | |||||||||
| NPI: | 1396820189 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PERKINS | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6121 N THESTA ST | ||||||||
| Address2: | 204 | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937108603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594387390 | ||||||||
| FaxNumber: | 5594387166 | ||||||||
| Practice Location | |||||||||
| Address1: | 6121 N THESTA | ||||||||
| Address2: | STE 204 | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594387390 | ||||||||
| FaxNumber: | 5594387166 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2006 | ||||||||
| LastUpdateDate: | 07/14/2008 | ||||||||
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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 | 207RH0003X | A41513 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 00A415130 | 05 | CA | MEDICAID | CE9729 | 01 | CA | RAILROAD MEDICARE | OTHER | GR0079792 | 05 | CA | MEDICAID | GR0079793 | 05 | CA | MEDICAID | 900001891 | 01 | CA | RAILROAD MEDICARE | OTHER | ZZZ61936Z | 01 | CA | BLUE SHIELD | OTHER |