Provider Demographics
NPI:1659542561
Name:CHRISTOPHER F AMSDEN MD
Entity Type:Organization
Organization Name:CHRISTOPHER F AMSDEN MD
Other - Org Name:MODESTO PROCEDURE SUITE, INC.
Other - Org Type:Doing Business As
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 1:1524 MCHENRY AVE STE 470
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4572
Mailing Address - Country:US
Mailing Address - Phone:209-525-8292
Mailing Address - Fax:209-525-8295
Practice Address - Street 1:1524 MCHENRY AVE STE 470
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4572
Practice Address - Country:US
Practice Address - Phone:209-525-8292
Practice Address - Fax:209-525-8295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ13924ZMedicare PIN