Provider Demographics
NPI:1316227093
Name:CHRISTOPHER S. VERBIN, M.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:CHRISTOPHER S. VERBIN, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:
Authorized Official - Last Name:TIOMICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-539-6500
Mailing Address - Street 1:3600 LOMITA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3900
Mailing Address - Country:US
Mailing Address - Phone:310-539-6500
Mailing Address - Fax:310-539-0147
Practice Address - Street 1:3600 LOMITA BLVD
Practice Address - Street 2:SUITE #100
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3900
Practice Address - Country:US
Practice Address - Phone:310-539-6500
Practice Address - Fax:310-539-0147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG76352208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG76352OtherID #
CAF69150Medicare UPIN