Basic Information
Provider Information
NPI: 1871980292
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEBEAU
FirstName: CHRISTOPHER
MiddleName: JOHN
NamePrefix: DR.
NameSuffix: JR.
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1900 N. HIGLEY ROAD
Address2: ATTN: AMANDA GUMP/HOSPITALIST TEAM
City: GILBERT
State: AZ
PostalCode: 85234
CountryCode: US
TelephoneNumber: 4805432034
FaxNumber: 4805432647
Practice Location
Address1: 1800 E. FLORENCE BLVD.
Address2: ATTN: AMANDA GUMP/HOSPITALIST TEAM
City: CASA GRANDE
State: AZ
PostalCode: 85122
CountryCode: US
TelephoneNumber: 4805432034
FaxNumber: 4805432647
Other Information
ProviderEnumerationDate: 04/23/2015
LastUpdateDate: 09/18/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X58529AZN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X58529AZY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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