Provider Demographics
NPI:1720153307
Name:WATKINS, CHRISTOPHER T (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:T
Last Name:WATKINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 FULLERTON RD
Mailing Address - Street 2:
Mailing Address - City:LA HABRA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:90631-8413
Mailing Address - Country:US
Mailing Address - Phone:562-691-9887
Mailing Address - Fax:562-691-9887
Practice Address - Street 1:1645 FULLERTON RD
Practice Address - Street 2:
Practice Address - City:LA HABRA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:90631-8413
Practice Address - Country:US
Practice Address - Phone:562-691-9887
Practice Address - Fax:562-691-9887
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28869111N00000X, 111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology
No111N00000XChiropractic ProvidersChiropractor