Provider Demographics
NPI:1588631253
Name:CANGA, CRISTINO C III (MD)
Entity Type:Individual
Prefix:
First Name:CRISTINO
Middle Name:C
Last Name:CANGA
Suffix:III
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:W129N7055 NORTHFIELD DR
Mailing Address - Street 2:GASTROENTEROLOGY
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-0538
Mailing Address - Country:US
Mailing Address - Phone:262-253-5400
Mailing Address - Fax:262-253-3339
Practice Address - Street 1:2801 W KK RIVER PKWY
Practice Address - Street 2:SUITE 1030
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-3669
Practice Address - Country:US
Practice Address - Phone:414-908-6500
Practice Address - Fax:414-385-2980
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2017-03-20
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Provider Licenses
StateLicense IDTaxonomies
WI40832-020207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1588631253Medicaid
WI736012629Medicare PIN
WI1588631253Medicaid