Provider Demographics
NPI:1093993263
Name:ERICKSON, CHRISTOPHER PHILLIPE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:PHILLIPE
Last Name:ERICKSON
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 1:6605 NANCY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2253
Mailing Address - Country:US
Mailing Address - Phone:858-750-2983
Mailing Address - Fax:858-750-2984
Practice Address - Street 1:6605 NANCY RIDGE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2253
Practice Address - Country:US
Practice Address - Phone:858-750-2983
Practice Address - Fax:858-750-2984
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-09
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6122207ZP0102X, 207ZD0900X
CAA109927207ND0900X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology