Provider Demographics
NPI:1780829119
Name:OBATA, CHRISTINE AKEMI (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:AKEMI
Last Name:OBATA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:2210 E ILLINOIS AVE
Practice Address - Street 2:401
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2125
Practice Address - Country:US
Practice Address - Phone:559-320-0580
Practice Address - Fax:559-320-0582
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA995032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry