Provider Demographics
NPI:1407869431
Name:FOREST, CHRISTINE D (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:D
Last Name:FOREST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:13563 VIA SAN REMO
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709
Mailing Address - Country:US
Mailing Address - Phone:909-465-9949
Mailing Address - Fax:909-591-6450
Practice Address - Street 1:116 N ROBERTSON BLVD
Practice Address - Street 2:#907
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-358-9499
Practice Address - Fax:310-358-9409
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA723752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A72375Medicare ID - Type Unspecified
H73978Medicare UPIN