Provider Demographics
NPI:1518952498
Name:CIAMPA, CHRISTOPHER P (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:P
Last Name:CIAMPA
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 1:10949 ALONDRA BLVD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-5403
Mailing Address - Country:US
Mailing Address - Phone:562-864-8590
Mailing Address - Fax:562-462-1465
Practice Address - Street 1:10949 ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-5403
Practice Address - Country:US
Practice Address - Phone:562-864-8590
Practice Address - Fax:562-462-1465
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT8948T152W00000X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0089480Medicaid
CASD0089480Medicaid