Provider Demographics
NPI:1093873044
Name:CHRISTENSEN, CHRISTIAN OLAF (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:OLAF
Last Name:CHRISTENSEN
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 1:799 E RIALTO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92415-1005
Mailing Address - Country:US
Mailing Address - Phone:909-383-3287
Mailing Address - Fax:909-386-8325
Practice Address - Street 1:799 E RIALTO AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-1005
Practice Address - Country:US
Practice Address - Phone:909-383-3287
Practice Address - Fax:909-386-8325
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG024402083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine