Provider Demographics
NPI:1174171409
Name:CHRISTINA N JENKINS MD
Entity type:Organization
Organization Name:CHRISTINA N JENKINS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-603-4200
Mailing Address - Street 1:26691 PLAZA STE 150
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6347
Mailing Address - Country:US
Mailing Address - Phone:949-348-2900
Mailing Address - Fax:949-348-0960
Practice Address - Street 1:26691 PLAZA STE 150
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6347
Practice Address - Country:US
Practice Address - Phone:949-348-2900
Practice Address - Fax:949-348-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty