Provider Demographics
NPI:1164426490
Name:PRICE, CHRISTOPHER A (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:A
Last Name:PRICE
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 1:5301 F ST STE 112
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3220
Mailing Address - Country:US
Mailing Address - Phone:916-868-6300
Mailing Address - Fax:916-868-6301
Practice Address - Street 1:5301 F ST STE 112
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3220
Practice Address - Country:US
Practice Address - Phone:916-868-6300
Practice Address - Fax:916-868-6301
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2012-02-03
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
CAA55084207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA200036445OtherTAX ID
CAG49798Medicare UPIN
CA200036445OtherTAX ID