Provider Demographics
NPI:1619101276
Name:MORA, CHRISTINA N (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:N
Last Name:MORA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTINA
Other - Middle Name:N
Other - Last Name:BLOCH MORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5821 JAMESON CT
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-0890
Mailing Address - Country:US
Mailing Address - Phone:916-486-0411
Mailing Address - Fax:
Practice Address - Street 1:2901 SQUALICUM PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1851
Practice Address - Country:US
Practice Address - Phone:360-788-6360
Practice Address - Fax:360-788-6376
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA120255207V00000X
WAMD61157316207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology