Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A129294 | CA |
N | 111NI0900X | Internist | A129294 | CA |
N | 207RA0401X | Internist - Addiction Medicine | A129294 | CA |
Y | 207RH0002X | Hospice and Palliative Medicine | A129294 | CA |
NPI | 1023365939 |
---|---|
Provider Name | Dr. Christopher Lee Metchnikoff |
First Address | Torrance, CA 90509-2910 |
Second Address | Sylmar, CA 91342-1437 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2012 |
Last Update Date | 19/12/2019 |