Provider Demographics
NPI:1730216680
Name:CHRISTENSEN, STEPHEN KAY (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:KAY
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:22681 LAKE FOREST DR
Mailing Address - Street 2:STE A-2
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-1794
Mailing Address - Country:US
Mailing Address - Phone:949-837-2121
Mailing Address - Fax:949-837-6215
Practice Address - Street 1:22681 LAKE FOREST DR
Practice Address - Street 2:STE A-2
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-1794
Practice Address - Country:US
Practice Address - Phone:949-837-2121
Practice Address - Fax:949-837-6215
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA8694T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU300095Medicare UPIN