Provider Demographics
NPI:1346488467
Name:WHITE, CHRISTOPHER D (DPT, MSPT, OCS, EMT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:D
Last Name:WHITE
Suffix:
Gender:M
Credentials:DPT, MSPT, OCS, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1131 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2061
Mailing Address - Country:US
Mailing Address - Phone:424-259-7140
Mailing Address - Fax:424-259-7156
Practice Address - Street 1:1635 AURORA CT FL 4
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2541
Practice Address - Country:US
Practice Address - Phone:720-848-2000
Practice Address - Fax:720-848-2058
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT30302225100000X
COPTL.0014229225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABN506ZMedicare PIN