Provider Demographics
NPI:1902232093
Name:DAVID BRUCE CHRISTIAN, MD
Entity Type:Organization
Organization Name:DAVID BRUCE CHRISTIAN, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:F
Authorized Official - Last Name:CHRISTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-664-0434
Mailing Address - Street 1:500 OLD RIVER RD STE 145
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9509
Mailing Address - Country:US
Mailing Address - Phone:661-664-0434
Mailing Address - Fax:661-664-0432
Practice Address - Street 1:500 OLD RIVER RD STE 145
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9509
Practice Address - Country:US
Practice Address - Phone:661-664-0434
Practice Address - Fax:661-664-0432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77665207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A776652Medicare PIN
CAH50607Medicare UPIN