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General NPI Number Information
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NPI Number | 1043669229
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Entity Type | Individual
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Provider Name | CHRISTIAN BENEDICT CRUZ FAGEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 757 WESTWOOD PLZ
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City | LOS ANGELES
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State | CA
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Zip | 90095-1461
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Country | US
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Telephone | 102-679-6433
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Fax | 310-267-3840
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90045-5631
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 25MA10652900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A180566
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License Number State | CA
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