Provider Demographics
NPI:1225013303
Name:KARLE, CHRISTIE DIANE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:DIANE
Last Name:KARLE
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5962 LA PLACE CT
Mailing Address - Street 2:STE 170
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-8807
Mailing Address - Country:US
Mailing Address - Phone:800-929-4776
Mailing Address - Fax:760-931-8370
Practice Address - Street 1:5772 BOLSA AVE
Practice Address - Street 2:STE 101
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-1134
Practice Address - Country:US
Practice Address - Phone:714-897-3589
Practice Address - Fax:714-897-1316
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT27527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT27527AMedicare ID - Type Unspecified