Provider Demographics
NPI:1376647560
Name:CAMPBELL, CHRISTOPHER L (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:L
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2241 SUNSET BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-4295
Mailing Address - Country:US
Mailing Address - Phone:916-435-2700
Mailing Address - Fax:916-435-2701
Practice Address - Street 1:10004 BLUE OAKS BLVD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-5146
Practice Address - Country:US
Practice Address - Phone:916-435-2700
Practice Address - Fax:916-435-2701
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7052207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX70520Medicaid
CAF37780Medicare UPIN
CA00AX70520Medicaid