Individual
CHRISTINE MARIE THEARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
30131 TOWN CENTER DRIVE, SUITE # 237, LAGUNA NIGUEL, CA 92677
(949) 495-0800
(949) 495-0805
Mailing address
30131 TOWN CENTER DRIVE, SUITE # 237, LAGUNA NIGUEL, CA 92677
(949) 495-0800
(949) 495-0805
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
C50353
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C50353
STATE LICENSE NUMBER
CA
Enumeration date
11/07/2006
Last updated
07/22/2010
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