Provider Demographics
NPI:1053350561
Name:LANGELL, CHRISTINE EVE (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:EVE
Last Name:LANGELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 KNOWLES DR
Mailing Address - Street 2:STE 117
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1542
Mailing Address - Country:US
Mailing Address - Phone:408-358-1234
Mailing Address - Fax:408-358-2202
Practice Address - Street 1:15000 LOS GATOS BLVD 1
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2017
Practice Address - Country:US
Practice Address - Phone:408-358-1234
Practice Address - Fax:408-358-2202
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2020-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA069383207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H08473Medicare UPIN