Provider Demographics
NPI:1912062894
Name:FILIPPELLI, CHRISTEL A (OD)
Entity Type:Individual
Prefix:
First Name:CHRISTEL
Middle Name:A
Last Name:FILIPPELLI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHRISTEL
Other - Middle Name:A
Other - Last Name:VESSOV
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 MILLS CIR
Mailing Address - Street 2:#516
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-5207
Mailing Address - Country:US
Mailing Address - Phone:909-484-3031
Mailing Address - Fax:909-484-3394
Practice Address - Street 1:72840 HIGHWAY 111
Practice Address - Street 2:PALM DESERT TOWN CENTER #F201
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3324
Practice Address - Country:US
Practice Address - Phone:760-341-6324
Practice Address - Fax:760-341-3725
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAT8341152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU13530Medicare UPIN