Provider Demographics
NPI:1740294321
Name:CHRISTENSEN, TODD E (MD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:E
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:280 SIERRA COLLEGE DR STE 105
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5763
Practice Address - Country:US
Practice Address - Phone:530-477-4480
Practice Address - Fax:530-477-3100
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN50469207X00000X, 207X00000X
CAG72325207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN50469OtherLICENSE
CA00G723251Medicaid
TN1532386OtherBLUECARE
TN1532386Medicaid
TN4356310OtherBCBST
TNP01225982OtherRAILROAD MEDICARE
TNP01225982OtherRAILROAD MEDICARE
TN50469OtherLICENSE
TNP01225982OtherRAILROAD MEDICARE