Provider Demographics
NPI:1629842794
Name:CHRISTOPHER MIGDAL, MD, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:CHRISTOPHER MIGDAL, MD, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MIGDAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-672-8991
Mailing Address - Street 1:810 COLLEGE AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:KENTFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:810 COLLEGE AVE STE 3
Practice Address - Street 2:
Practice Address - City:KENTFIELD
Practice Address - State:CA
Practice Address - Zip Code:94904-2532
Practice Address - Country:US
Practice Address - Phone:415-906-2991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty