Provider Demographics
NPI:1952401069
Name:CHRISTOPHER J. LABBAN, DO.PC
Entity Type:Organization
Organization Name:CHRISTOPHER J. LABBAN, DO.PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:LABBAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-497-9414
Mailing Address - Street 1:3048 E BASELINE RD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-7286
Mailing Address - Country:US
Mailing Address - Phone:480-497-9414
Mailing Address - Fax:480-497-8430
Practice Address - Street 1:3048 E BASELINE RD
Practice Address - Street 2:SUITE 113
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-7286
Practice Address - Country:US
Practice Address - Phone:480-497-9414
Practice Address - Fax:480-497-8430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ66807Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER