Provider Demographics
NPI: | 1619990710 |
---|---|
Name: | FINKEMEIER, CHRISTOPHER GLENN (MD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | CHRISTOPHER |
Middle Name: | GLENN |
Last Name: | FINKEMEIER |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 5897 GRANITE HILLS DR S |
Mailing Address - Street 2: | |
Mailing Address - City: | GRANITE BAY |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 95746-6760 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 916-781-1382 |
Mailing Address - Fax: | 916-781-1382 |
Practice Address - Street 1: | 6620 COYLE AVE STE 212 |
Practice Address - Street 2: | |
Practice Address - City: | CARMICHAEL |
Practice Address - State: | CA |
Practice Address - Zip Code: | 95608-6337 |
Practice Address - Country: | US |
Practice Address - Phone: | 916-536-9455 |
Practice Address - Fax: | 916-536-9424 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2006-07-26 |
Last Update Date: | 2014-10-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | G87303 | 207X00000X, 207XX0801X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | |
No | 207XX0801X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
G59869 | Medicare UPIN | ||
CA | 00G873030 | Medicare PIN |