Basic Information
Provider Information
NPI: 1750683975
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRIS
FirstName: CHRISTOPHER
MiddleName: ABROM
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 23905 CLINTON KEITH RD
Address2: 114-411
City: WILDOMAR
State: CA
PostalCode: 925957897
CountryCode: US
TelephoneNumber: 8662840482
FaxNumber: 8889771204
Practice Location
Address1: 21750 CENTER COURT DR. S
Address2: SUITE 650
City: CERRITOS
State: CA
PostalCode: 90703
CountryCode: US
TelephoneNumber: 3236288671
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/19/2010
LastUpdateDate: 03/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AS0400XPA21322CAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical

No ID Information.


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