Provider Demographics
NPI:1053489047
Name:DOYLE, CHRISTINA A (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:A
Last Name:DOYLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:A
Other - Last Name:GIBOWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:610 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-4221
Mailing Address - Country:US
Mailing Address - Phone:831-655-9881
Mailing Address - Fax:831-655-9883
Practice Address - Street 1:610 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-4221
Practice Address - Country:US
Practice Address - Phone:831-655-9881
Practice Address - Fax:831-655-9883
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25538225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00221094Medicare ID - Type Unspecified
CAOPT255381Medicare PIN