=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467642892
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CRISTINA YOLANDA MACHAIN DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2007
-----------------------------------------------------
Last Update Date | 05/10/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5160 VINELAND AVE #105
-----------------------------------------------------
City | NORTH HOLLYWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-761-8899
-----------------------------------------------------
Fax | 818-761-8949
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5160 VINELAND AVE #105
-----------------------------------------------------
City | NORTH HOLLYWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-761-8899
-----------------------------------------------------
Fax | 818-761-8949
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | D50487
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 50847
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------