MEDICARE: CHRISTOPHER S CRUZ M.D.

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
1	207R00000X	Internal Medicine Physician	10545	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295792182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER S CRUZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 28971
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89126-2971
Country	:	US
Telephone Number	:	702-220-9667
Fax Number	:	702-220-5277

Provider Business Practice Location Address
First Line	:	5450 W SAHARA AVE
Second Line	:	SUITE 130
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0380
Country	:	US
Telephone Number	:	702-220-9667
Fax Number	:	702-220-5277

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	09/04/2013

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