Provider Demographics
NPI:1710084934
Name:CHRIS S. PALLIA, MD, APC
Entity Type:Organization
Organization Name:CHRIS S. PALLIA, MD, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:STERLING
Authorized Official - Last Name:PALLIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-435-7282
Mailing Address - Street 1:PO BOX 261386
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92196-1386
Mailing Address - Country:US
Mailing Address - Phone:619-435-7282
Mailing Address - Fax:619-435-3723
Practice Address - Street 1:230 PROSPECT PL
Practice Address - Street 2:SUITE 230
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118-1978
Practice Address - Country:US
Practice Address - Phone:619-435-7282
Practice Address - Fax:619-435-3723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74481207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5471980001Medicare NSC
CAW19101Medicare PIN