Mark R Christensen, O.D., Inc., a Professional Optometric Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT 7874 TPA Issued in CA

Legal business name

MARK R CHRISTENSEN, O.D., INC., A PROFESSIONAL OPTOMETRIC CORPORATION

Practice address

1710 Pennsylvania Ave Ste B
Fairfield, CA 94533-3549

Phone

(707) 425-2187

Fax

(707) 434-8130

NPI assigned

Aug 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark R Christensen, O.D.NPI 1518038108

Title

President

Phone

(707) 425-2187

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark R Christensen, O.D.

  • Optometrist
  • Fairfield, CA
  • NPI 1518038108
  Medicare reassignment NPD Authorized official
• Frank W Hull, MD

  • Ophthalmology Physician
  • Fairfield, CA
  • NPI 1720071327
  NPD (past)
• Kevin Jeffrey Page

  • Optometrist
  • Fairfield, CA
  • NPI 1316884414
  NPD (past)

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274659200000",
    "number": "1881885309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 PENNSYLVANIA AVE STE B",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333549",
            "telephone_number": "707-425-2187",
            "fax_number": "707-434-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 PENNSYLVANIA AVE STE B",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333549",
            "telephone_number": "707-425-2187",
            "fax_number": "707-434-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK R CHRISTENSEN, O.D., INC., A PROFESSIONAL OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-08",
        "last_updated": "2010-05-24",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-425-2187",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 7874 TPA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noel Marcaida
• Cesar Mardones
• Andrew Marino
• Mark Choi DDS Inc
• Mark J Warner, DDS, Inc
• Inna M Markiv, P.A.
• Jazlene Rose Marquez
• Samantha Renee Marquez
• Lawanda Jerus Marie Marrero
• Margaux Marrocco

• Optometrist in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.