Provider Demographics
NPI:1376834572
Name:URBAND, CHRISTOPHER EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:EDWARD
Last Name:URBAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11939 RANCHO BERNARDO RD STE 115
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2073
Mailing Address - Country:US
Mailing Address - Phone:858-705-6130
Mailing Address - Fax:858-400-4080
Practice Address - Street 1:11939 RANCHO BERNARDO RD STE 115
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2073
Practice Address - Country:US
Practice Address - Phone:858-705-6130
Practice Address - Fax:858-400-4080
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA144223207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty