Provider Demographics
NPI:1689818874
Name:CHRISTOPHER STALBERG, MD, PLLC
Entity Type:Organization
Organization Name:CHRISTOPHER STALBERG, MD, PLLC
Other - Org Name:OPTUM PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:X
Authorized Official - Credentials:
Authorized Official - Phone:702-480-2550
Mailing Address - Street 1:14418 W MEEKER BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-5291
Mailing Address - Country:US
Mailing Address - Phone:623-544-8400
Mailing Address - Fax:623-544-8989
Practice Address - Street 1:14418 W MEEKER BLVD
Practice Address - Street 2:#210
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5291
Practice Address - Country:US
Practice Address - Phone:623-544-8400
Practice Address - Fax:623-544-8989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-01
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25355207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty