Christian Hackshaw, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

C51195 Issued in CA

Practice address

5176 Hill Rd E
Emergency Department
Lakeport, CA 95453-6300

Phone

(707) 262-5050

Fax

(707) 262-5053

NPI assigned

Jun 14, 2006

Last updated

Jun 26, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1881637023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3843 GLEBE RD",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954518251",
            "telephone_number": "707-295-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5176 HILL RD E",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536300",
            "telephone_number": "707-262-5050",
            "fax_number": "707-262-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKSHAW",
        "first_name": "CHRISTIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C51195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C511950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurieg Lee Grogg III
• Jaimee Gronendyke, MHRS
• Linda Gude, PSY.D
• Kimbralee Guerra, REHAB SPECIALIST
• Diane Gunther, RN
• Gregory Sean Hadfield, PA-C
• James M Hagan, DPM
• Jodi Hansen
• Katherine Claire Harris, PUBLIC HEALTH NURSE
• Laura Ann Harris

• Emergency Medicine Physician in Lakeport, CA
• Providers in Lakeport, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.