Provider Demographics
NPI:1275273286
Name:LUNA, CRISTOBAL
Entity Type:Individual
Prefix:
First Name:CRISTOBAL
Middle Name:
Last Name:LUNA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6767 W TROPICANA AVE STE 226
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-4911
Mailing Address - Country:US
Mailing Address - Phone:818-521-1848
Mailing Address - Fax:
Practice Address - Street 1:6767 W TROPICANA AVE STE 226
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-4911
Practice Address - Country:US
Practice Address - Phone:818-521-1848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRCS.RVS.00070394246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography