Provider Demographics
NPI:1467977637
Name:CHRISTIE, RICHARD NORMAN
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:NORMAN
Last Name:CHRISTIE
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 1:501 WASHINGTON ST STE 725
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2241
Mailing Address - Country:US
Mailing Address - Phone:949-887-6109
Mailing Address - Fax:
Practice Address - Street 1:501 WASHINGTON ST STE 725
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2241
Practice Address - Country:US
Practice Address - Phone:949-887-6109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-09
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44370207VX0000X
CAA044370207VX0000X
CA44370207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics