Provider Demographics
NPI:1457482630
Name:RISSER, CHRISTIAN F (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:F
Last Name:RISSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9250 N 3RD ST
Mailing Address - Street 2:STE. 3030
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2412
Mailing Address - Country:US
Mailing Address - Phone:602-944-3347
Mailing Address - Fax:602-944-3448
Practice Address - Street 1:9250 N 3RD ST
Practice Address - Street 2:STE. 3030
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2412
Practice Address - Country:US
Practice Address - Phone:602-944-3347
Practice Address - Fax:602-944-3448
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6484207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ240086Medicaid
AZ240086Medicaid
AZD00190Medicare UPIN