Provider Demographics
NPI:1033453121
Name:NEAL, CHRISTOPHER JONATHAN (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JONATHAN
Last Name:NEAL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24630 WASHINGTON AVE
Mailing Address - Street 2:STE. 200
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6131
Mailing Address - Country:US
Mailing Address - Phone:951-696-9353
Mailing Address - Fax:951-973-7216
Practice Address - Street 1:451 SW SEDGWICK RD STE 310
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98367-6447
Practice Address - Country:US
Practice Address - Phone:951-696-9353
Practice Address - Fax:951-973-7216
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 39878225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPT60795407OtherPT LICENSE
CAHA932YMedicare PIN