Provider Demographics
NPI:1265636336
Name:CAMPAGNA, CHRISTOPHER JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:CAMPAGNA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 S FORTUNA BLVD
Mailing Address - Street 2:
Mailing Address - City:FORTUNA
Mailing Address - State:CA
Mailing Address - Zip Code:95540-3034
Mailing Address - Country:US
Mailing Address - Phone:707-682-6155
Mailing Address - Fax:
Practice Address - Street 1:739 S FORTUNA BLVD
Practice Address - Street 2:
Practice Address - City:FORTUNA
Practice Address - State:CA
Practice Address - Zip Code:95540-3034
Practice Address - Country:US
Practice Address - Phone:707-682-6155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007533111NR0400X
CADC34488111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation