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NPI Code Detail

MEDICARE: CHRISTIAN ALEXANDER CRUZ MD

MEDICARE: CHRISTIAN ALEXANDER CRUZ MD
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
1207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianA184402CA
2390200000XStudent in an Organized Health Care Education/Training Program

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1VAD000OTHERMEDICARE UPIN

General Provider Information

NPI Number : 1649770348
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN ALEXANDER CRUZ MD
Provider Business Mailing Address
First Line : 1 JARRETT WHITE RD
Second Line :
City : TRIPLER ARMY MEDICAL CENTER
State : HI
Zip : 96859-5001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9300 DEWITT LOOP
Second Line :
City : FORT BELVOIR
State : VA
Zip : 22060-5285
Country : US
Telephone Number : 215-498-0653
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2018
Last Update Date : 01/06/2026

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