Chris Carlucci Bacchi, MD
Individual provider Active NPI Internal Medicine Physician · Kenfield, CA
NPI 1346468014 · NPPES record last updated Mar 6, 2019
Key facts
- NPI
- 1346468014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A60805 (CA)
- Practice address
- 1030 Sir Francis Drake Blvd Suite #110
Kenfield, CA 94904 - Phone
- (415) 461-1036
- Fax
- (415) 461-1043
- NPI assigned
- Apr 20, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A60805 | CA | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A60805 | CA | Yes |
Addresses
Primary practice location
1030 Sir Francis Drake Blvd Suite #110
Kenfield, CA 94904
Mailing address
1030 Sir Francis Drake Blvd Suite #110
Kenfield, CA 94904
Phone (415) 461-1036
Other names
- Dr. Christine Ciesielski-Carlucci
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.