Provider Demographics
NPI:1467614735
Name:CHRISTOPHER C. NINH MD, INC.
Entity Type:Organization
Organization Name:CHRISTOPHER C. NINH MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:C
Authorized Official - Last Name:NINH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-876-4876
Mailing Address - Street 1:11190 WARNER AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4047
Mailing Address - Country:US
Mailing Address - Phone:714-432-9990
Mailing Address - Fax:714-432-9988
Practice Address - Street 1:11190 WARNER AVE STE 306
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4047
Practice Address - Country:US
Practice Address - Phone:714-432-9990
Practice Address - Fax:714-432-9988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98528207X00000X
CA20A11544207XS0117X
CAPT38861225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6318170001Medicare NSC