Provider Demographics
NPI:1588804462
Name:CHRISTOPHER F. AMSDEN, MD, INC.
Entity type:Organization
Organization Name:CHRISTOPHER F. AMSDEN, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:F
Authorized Official - Last Name:AMSDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-525-8292
Mailing Address - Street 1:1360 W 6TH ST
Mailing Address - Street 2:STE. 150
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-3514
Mailing Address - Country:US
Mailing Address - Phone:209-525-8292
Mailing Address - Fax:209-525-8295
Practice Address - Street 1:1360 W 6TH ST
Practice Address - Street 2:WEST BUILDING, SUITE 150
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-3514
Practice Address - Country:US
Practice Address - Phone:310-833-2222
Practice Address - Fax:310-833-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-04
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG570402081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACY949BOtherPTAN
CAG57040OtherCA LIC