Provider Demographics
NPI:1497827935
Name:LIKENS, CHRISTOPHER PAUL (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:PAUL
Last Name:LIKENS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 BARRANCA PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4797
Mailing Address - Country:US
Mailing Address - Phone:949-857-0676
Mailing Address - Fax:949-857-2175
Practice Address - Street 1:4505 BARRANCA PKWY STE C
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4797
Practice Address - Country:US
Practice Address - Phone:949-857-0676
Practice Address - Fax:949-857-2175
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7839T152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACK733ZMedicare PIN