Provider Demographics
NPI:1821404450
Name:GIRGIS, CHRISTINE SOLIMAN
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:SOLIMAN
Last Name:GIRGIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11946 HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-3016
Mailing Address - Country:US
Mailing Address - Phone:310-675-1136
Mailing Address - Fax:310-970-1447
Practice Address - Street 1:11946 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-3016
Practice Address - Country:US
Practice Address - Phone:310-675-1136
Practice Address - Fax:310-970-1447
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA144427207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine