Provider Demographics
NPI:1639056112
Name:WOODIE, CHRISTIAN STEVEN (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:STEVEN
Last Name:WOODIE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ADMINISTRATION CIR
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-6104
Mailing Address - Country:US
Mailing Address - Phone:760-932-8030
Mailing Address - Fax:
Practice Address - Street 1:1 ADMINISTRATION CIR
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-6104
Practice Address - Country:US
Practice Address - Phone:760-939-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant