Provider Demographics
NPI:1205871787
Name:TAM, CHRISTINA PACIO (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:PACIO
Last Name:TAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTINA
Other - Middle Name:IGNACIO
Other - Last Name:PACIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1000 REGENCY CT
Mailing Address - Street 2:STE. 100
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3074
Mailing Address - Country:US
Mailing Address - Phone:419-882-0588
Mailing Address - Fax:419-885-3070
Practice Address - Street 1:1000 REGENCY CT
Practice Address - Street 2:STE. 100
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3074
Practice Address - Country:US
Practice Address - Phone:419-882-0588
Practice Address - Fax:419-885-3070
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35084104207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2532165Medicaid
OHP00600624OtherRAILROAD MEDCIARE
OH100670OtherPHYSICIANS HEALTH COLLABO
OH202016482OtherWOOD CARE NET
OH000000614557OtherANTHEM
OH04684OtherPARAMOUNT
OH341100646OtherTAXPAYER IDENTIFICATION NUMBER - GROUP
OH202016482028OtherCARESOURCE
OH728834OtherBUCKEYE
OH7228612OtherAETNA
OH202016482OtherMERCY HEALTH PHO
OH2402805OtherUNITED HEALTH
OH7228612OtherAETNA
OHH86590Medicare UPIN