Provider Demographics
NPI:1154313732
Name:HALLMAN, CHRISTIAAN P (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTIAAN
Middle Name:P
Last Name:HALLMAN
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 1:800 FAIRMOUNT AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3150
Mailing Address - Country:US
Mailing Address - Phone:626-795-2007
Mailing Address - Fax:626-795-2012
Practice Address - Street 1:800 FAIRMOUNT AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3150
Practice Address - Country:US
Practice Address - Phone:626-795-2007
Practice Address - Fax:626-795-2012
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54658207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA54658BMedicare ID - Type Unspecified
CAG66091Medicare UPIN