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NPI Code Detail

MEDICARE: CRISTOBAL GALVAN M.A.

MEDICARE: CRISTOBAL GALVAN M.A.
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
1106H00000XMarriage & Family TherapistCA

General Provider Information

NPI Number : 1689458689
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRISTOBAL GALVAN M.A.
Provider Business Mailing Address
First Line : 3869 SPAD PL
Second Line :
City : CULVER CITY
State : CA
Zip : 90232-3607
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 301 N PRAIRIE AVE STE 510
Second Line :
City : INGLEWOOD
State : CA
Zip : 90301-4512
Country : US
Telephone Number : 310-258-9677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2023
Last Update Date : 08/21/2023

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Directions to “ CRISTOBAL GALVAN M.A.” Practice Location

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