Provider Demographics
NPI:1841398542
Name:FRATINO, CHRISTINE VALENTINA (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:VALENTINA
Last Name:FRATINO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 FRUITVALE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-2418
Mailing Address - Country:US
Mailing Address - Phone:510-535-4000
Mailing Address - Fax:510-535-4128
Practice Address - Street 1:3451 E 12TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-3463
Practice Address - Country:US
Practice Address - Phone:510-535-4000
Practice Address - Fax:510-535-4128
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8629207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW20A8629AMedicare ID - Type Unspecified
W20A8629BMedicare ID - Type Unspecified
CAW20A8629DMedicare ID - Type Unspecified
CAW20A8629CMedicare ID - Type Unspecified