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General NPI Number Information
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NPI Number | 1649764374
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Entity Type | Individual
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Provider Name | CRISTINE PHILINA NOCHE ONG NP
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Gender | Female
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Dates
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Enumeration Date | 06/16/2018
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Last Update Date | 01/21/2022
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Provider Practice Location Address
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Address Line | 2701 OCEAN PARK BLVD STE 130
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City | SANTA MONICA
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State | CA
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Zip | 90405-5244
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Country | US
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Telephone | 310-450-1200
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Fax | 310-450-8830
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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 | 310-301-5138
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 778305
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95008670
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License Number State | CA
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