Provider Demographics
NPI:1275703068
Name:MIN, CHRISTEEN (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTEEN
Middle Name:
Last Name:MIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CHRISTEEN
Other - Middle Name:
Other - Last Name:SIZEMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:27246 RED WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91381-2171
Mailing Address - Country:US
Mailing Address - Phone:703-314-8588
Mailing Address - Fax:
Practice Address - Street 1:27246 RED WILLOW CT
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91381-2171
Practice Address - Country:US
Practice Address - Phone:703-314-8588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35326152W00000X
MDTA2096152W00000X
VA0618001911152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist