Provider Demographics
NPI:1245911288
Name:RADFORD, CHRISTOPHER REX (CRNA, DNP)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:REX
Last Name:RADFORD
Suffix:
Gender:M
Credentials:CRNA, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4309 ALDERWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-0806
Mailing Address - Country:US
Mailing Address - Phone:916-397-7218
Mailing Address - Fax:
Practice Address - Street 1:333 PALOS VERDES BLVD APT 21
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-6380
Practice Address - Country:US
Practice Address - Phone:916-397-7218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95082500163W00000X
CA95002195367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse