Provider Demographics
NPI:1497812630
Name:CHRISTOPHER HOLDEN, M.D., INC.
Entity Type:Organization
Organization Name:CHRISTOPHER HOLDEN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-744-5000
Mailing Address - Street 1:438 E KATELLA AVE
Mailing Address - Street 2:B
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-4839
Mailing Address - Country:US
Mailing Address - Phone:714-744-5000
Mailing Address - Fax:714-744-5985
Practice Address - Street 1:438 E KATELLA AVE
Practice Address - Street 2:B
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-4839
Practice Address - Country:US
Practice Address - Phone:714-744-5000
Practice Address - Fax:714-744-5985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75635207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF73589Medicare UPIN
CAG75635Medicare ID - Type Unspecified