Provider Demographics
NPI:1447318944
Name:KAMEN, CHRISTOPHER (PT, DPT, COMT, ATC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:KAMEN
Suffix:
Gender:M
Credentials:PT, DPT, COMT, ATC
Other - Prefix:DR
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:KAMEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, DPT, COMT, ATC
Mailing Address - Street 1:23412 PACIFIC PARK DR
Mailing Address - Street 2:UNIT 35 A
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-5373
Mailing Address - Country:US
Mailing Address - Phone:949-680-5544
Mailing Address - Fax:
Practice Address - Street 1:30112 CROWN VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2042
Practice Address - Country:US
Practice Address - Phone:949-363-7716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2011-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT33011225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT33011OtherSTATE LICENSE
CAW19207Medicare ID - Type Unspecified