Provider Demographics
NPI:1245474881
Name:CRISTIANO, CHRISTIAN (MS)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:
Last Name:CRISTIANO
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:CHRISTIAN
Other - Middle Name:
Other - Last Name:CRISTIANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:6320 COMMODORE SLOAT DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5453
Mailing Address - Country:US
Mailing Address - Phone:323-935-3420
Mailing Address - Fax:323-935-5933
Practice Address - Street 1:6320 COMMODORE SLOAT DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5453
Practice Address - Country:US
Practice Address - Phone:323-935-3420
Practice Address - Fax:323-935-5933
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-27
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 12254171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist