Provider Demographics
NPI:1780689406
Name:FOGLAR, CHRISTIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:
Last Name:FOGLAR
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 1:6140 CAMINO VERDE DR STE L
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1401
Mailing Address - Country:US
Mailing Address - Phone:408-224-1267
Mailing Address - Fax:408-926-6858
Practice Address - Street 1:6140 CAMINO VERDE DR STE L
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1401
Practice Address - Country:US
Practice Address - Phone:408-224-1267
Practice Address - Fax:408-926-6858
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84652174400000X
CAA054508207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264598000Medicaid
FL264598000Medicaid
CA00A545081Medicare PIN