Provider Demographics
NPI:1396820189
Name:PERKINS, CHRISTOPHER R (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:R
Last Name:PERKINS
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 1:6121 N THESTA ST
Mailing Address - Street 2:204
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8603
Mailing Address - Country:US
Mailing Address - Phone:559-438-7390
Mailing Address - Fax:559-438-7166
Practice Address - Street 1:6121 N THESTA
Practice Address - Street 2:STE 204
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710
Practice Address - Country:US
Practice Address - Phone:559-438-7390
Practice Address - Fax:559-438-7166
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41513207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A415130Medicaid
CACE9729OtherRAILROAD MEDICARE
CAGR0079792Medicaid
CAGR0079793Medicaid
CA900001891OtherRAILROAD MEDICARE
CAZZZ61936ZOtherBLUE SHIELD
CAGR0079792Medicaid
CACE9729OtherRAILROAD MEDICARE
CAGR0079793Medicaid