Healthcare Provider Details

I. General information

NPI: 1841857919
Provider Name (Legal Business Name): KRIXIE VIVO SILANGCRUZ MD, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRIXIE ZIALCITA VIVO

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 01/14/2024
Certification Date: 01/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 E CARSON ST STE 101
CARSON CA
90745-2262
US

IV. Provider business mailing address

824 E CARSON ST STE 101
CARSON CA
90745-2262
US

V. Phone/Fax

Practice location:
  • Phone: 310-233-3203
  • Fax: 310-549-7010
Mailing address:
  • Phone: 310-233-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number7734
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number184885
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: