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NPI Code Detail

MEDICARE: CRISTINA SHALLENBERGER N.P.

MEDICARE: CRISTINA SHALLENBERGER N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner95002630CA

General Provider Information

NPI Number : 1043693245
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRISTINA SHALLENBERGER N.P.
Provider Business Mailing Address
First Line : 2021 SANTA MONICA BLVD
Second Line : SUITE 600 EAST
City : SANTA MONICA
State : CA
Zip : 90404-2208
Country : US
Telephone Number : 310-828-2282
Fax Number :
Provider Business Practice Location Address
First Line : 2021 SANTA MONICA BLVD
Second Line : SUITE 600 EAST
City : SANTA MONICA
State : CA
Zip : 90404-2208
Country : US
Telephone Number : 310-828-2282
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2015
Last Update Date : 07/07/2015

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Directions to “ CRISTINA SHALLENBERGER N.P.” Practice Location

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