Provider Demographics
NPI:1831346592
Name:CHRISTOPHER KASSAR D.O. INC.
Entity type:Organization
Organization Name:CHRISTOPHER KASSAR D.O. INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMI
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:PARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-335-3527
Mailing Address - Street 1:615 E FOOTHILL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-1255
Mailing Address - Country:US
Mailing Address - Phone:626-335-3527
Mailing Address - Fax:626-623-7233
Practice Address - Street 1:615 E FOOTHILL BLVD STE A
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-1255
Practice Address - Country:US
Practice Address - Phone:626-335-3527
Practice Address - Fax:626-623-7233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA036813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPENDINGMedicare PIN