Provider Demographics
NPI:1235409723
Name:OSBORNE, CRISTINE (DO)
Entity Type:Individual
Prefix:
First Name:CRISTINE
Middle Name:
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2941 MONTANA SKY DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-5155
Mailing Address - Country:US
Mailing Address - Phone:530-722-7937
Mailing Address - Fax:530-223-6430
Practice Address - Street 1:2941 MONTANA SKY DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-5155
Practice Address - Country:US
Practice Address - Phone:530-722-7937
Practice Address - Fax:530-223-6430
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A10013207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H87078Medicare UPIN