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General NPI Number Information
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NPI Number | 1851953400
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Entity Type | Individual
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Provider Name | CHRISTOPHER MAURICIO SOSA
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Gender | Male
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Dates
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Enumeration Date | 07/03/2019
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 16912 SAN FERNANDO MISSION BLVD
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City | GRANADA HILLS
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State | CA
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Zip | 91344-4249
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Country | US
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Telephone | 818-488-6160
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Fax |
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Provider Business Mailing Address
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Address Line | 11024 BALBOA BLVD # 295
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City | GRANADA HILLS
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State | CA
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Zip | 91344-5007
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Country | US
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Telephone | 818-366-0360
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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