Provider Demographics
NPI:1821198771
Name:COLE, CHRISTINE M (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:COLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:54433 FILE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-0001
Mailing Address - Country:US
Mailing Address - Phone:858-784-5767
Mailing Address - Fax:858-784-5933
Practice Address - Street 1:10820 N TORREY PINES RD
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1036
Practice Address - Country:US
Practice Address - Phone:858-554-3300
Practice Address - Fax:858-784-5933
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA357013363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS83317Medicare UPIN
CAWNP9401BMedicare PIN