Provider Demographics
NPI:1649935180
Name:WARNER, CHRISTOPHER J (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:WARNER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4052 32ND ST APT 6
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-2098
Mailing Address - Country:US
Mailing Address - Phone:253-686-6890
Mailing Address - Fax:
Practice Address - Street 1:1626 SWEETWATER RD STE AB
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-7645
Practice Address - Country:US
Practice Address - Phone:619-474-5916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-31
Last Update Date:2021-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301119225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty