Provider Demographics
NPI:1700197407
Name:BEAN, CHRISTOPHER RANDAL
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:RANDAL
Last Name:BEAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5905 PIERCE ST
Mailing Address - Street 2:#102
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-5558
Mailing Address - Country:US
Mailing Address - Phone:720-229-2314
Mailing Address - Fax:
Practice Address - Street 1:5905 PIERCE ST
Practice Address - Street 2:#102
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-5558
Practice Address - Country:US
Practice Address - Phone:720-229-2314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor