Basic Information
| Provider Information | |||||||||
| NPI: | 1497751457 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PALLIA | ||||||||
| FirstName: | CHRIS | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | PALLIA | ||||||||
| OtherFirstName: | CHRISTOPHER | ||||||||
| OtherMiddleName: | S | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 230 PROSPECT PL | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | CORONADO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921181978 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194357282 | ||||||||
| FaxNumber: | 6194353723 | ||||||||
| Practice Location | |||||||||
| Address1: | 230 PROSPECT PL | ||||||||
| Address2: | STE 230 | ||||||||
| City: | CORONADO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921181976 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194357282 | ||||||||
| FaxNumber: | 6194353723 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2005 | ||||||||
| LastUpdateDate: | 09/10/2008 | ||||||||
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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 | 207X00000X | A74481 | CA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.