Provider Demographics
NPI:1326148552
Name:WEINMAN, CHRISTOPHER MICHAEL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:WEINMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 E BARNETT RD
Mailing Address - Street 2:STE 201
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8210
Mailing Address - Country:US
Mailing Address - Phone:541-779-5007
Mailing Address - Fax:541-779-5022
Practice Address - Street 1:1311 E BARNETT RD STE 201
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8210
Practice Address - Country:US
Practice Address - Phone:541-779-5007
Practice Address - Fax:541-779-5022
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA01182363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
R136096Medicare PIN
Q74929Medicare UPIN