Provider Demographics
NPI:1639225444
Name:SUE, CHRISTOPHER MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:SUE
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 1:2081 STRANG AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-1470
Mailing Address - Country:US
Mailing Address - Phone:510-276-8045
Mailing Address - Fax:
Practice Address - Street 1:411 30TH ST
Practice Address - Street 2:SUITE 314
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3301
Practice Address - Country:US
Practice Address - Phone:510-273-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA881882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry