Healthcare Provider Details

I. General information

NPI: 1902122260
Provider Name (Legal Business Name): CRISTINA ACOSTA-PADRON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIA CRISTINA ACOSTA MD

II. Dates (important events)

Enumeration Date: 04/12/2010
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S GRAND AVE
LOS ANGELES CA
90015-3010
US

IV. Provider business mailing address

1400 S GRAND AVE SUITE 101
LOS ANGELES CA
90015-3048
US

V. Phone/Fax

Practice location:
  • Phone: 213-742-5880
  • Fax:
Mailing address:
  • Phone: 213-741-0801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA118467
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA118467
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: