Provider Demographics
NPI:1437417029
Name:MOORE, CHRISTOPHER ARTHUR (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ARTHUR
Last Name:MOORE
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 1:20642 JOHN DR
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5103
Mailing Address - Country:US
Mailing Address - Phone:510-785-5000
Mailing Address - Fax:
Practice Address - Street 1:20642 JOHN DR
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5103
Practice Address - Country:US
Practice Address - Phone:510-785-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60522339207Q00000X
CAC170476207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1437417029Medicaid