Organization
CHRISTABELLE CO MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTABELLE CO MD (CORPORATE OWNER/PRESIDENT)
(650) 808-9858
Entity
Organization
Contact information
Practice address
161 S SPRUCE AVE STE 205, SOUTH SAN FRANCISCO, CA 94080-4517
(650) 808-9848
(650) 808-9848
Mailing address
161 S SPRUCE AVE STE 205, SOUTH SAN FRANCISCO, CA 94080-4517
(650) 808-9848
(650) 808-9848
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A148358
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4066595
CORPORATION
CA
01
—
A148358
CALIFORNIA MEDICAL LICENSE
CA
Enumeration date
10/05/2017
Last updated
06/16/2018
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