Provider Demographics
NPI:1174655104
Name:CHRISTIAN, DOROTHY L (NP)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:L
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 POTRERO AVE # 3M
Mailing Address - Street 2:SFGH ORTHOPEDIC SURGERY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-5072
Mailing Address - Fax:415-647-3733
Practice Address - Street 1:1001 POTRERO AVE # 3M
Practice Address - Street 2:SFGH ORTHOPEDIC SURGERY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-5072
Practice Address - Fax:415-647-3733
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 546695163WM0705X
CANP11949363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Not Answered363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
963272OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
Q34207Medicare UPIN