Provider Demographics
NPI:1093778326
Name:ENGELMAN, CHRISTOPHER JAMES (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:ENGELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 S DE ANZA BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-3030
Mailing Address - Country:US
Mailing Address - Phone:408-252-7100
Mailing Address - Fax:408-257-8355
Practice Address - Street 1:431 MONTEREY AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-5319
Practice Address - Country:US
Practice Address - Phone:408-354-9510
Practice Address - Fax:408-395-1610
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69913207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A699130Medicaid
CA00A699130Medicare PIN
CAH78931Medicare UPIN