Provider Demographics
NPI:1447548326
Name:TERASAKI, CHRISTINE FLORIDA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:FLORIDA
Last Name:TERASAKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:CHRISTINE
Other - Middle Name:FLORIDA
Other - Last Name:LU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:24061 NEECE AVE
Mailing Address - Street 2:#12
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6527
Mailing Address - Country:US
Mailing Address - Phone:626-379-4194
Mailing Address - Fax:
Practice Address - Street 1:1000 E DOMINGUEZ ST
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-3600
Practice Address - Country:US
Practice Address - Phone:310-715-7755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21616363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant