Provider Demographics
NPI:1205239795
Name:CRISTIANO, BRIAN COOPER (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:COOPER
Last Name:CRISTIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16512 BURKE LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-4538
Mailing Address - Country:US
Mailing Address - Phone:909-252-7181
Mailing Address - Fax:909-345-2086
Practice Address - Street 1:16512 BURKE LN
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-4538
Practice Address - Country:US
Practice Address - Phone:909-252-7181
Practice Address - Fax:909-345-2086
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1381402085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Single Specialty