Provider Demographics
NPI:1467570697
Name:MAYER, CHRISTOPHER ERNEST
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ERNEST
Last Name:MAYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 PALISADES AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062
Mailing Address - Country:US
Mailing Address - Phone:831-338-2144
Mailing Address - Fax:831-338-0901
Practice Address - Street 1:13081 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BOULDER CREEK
Practice Address - State:CA
Practice Address - Zip Code:95006
Practice Address - Country:US
Practice Address - Phone:831-338-2144
Practice Address - Fax:831-338-0901
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH32350183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist