# SAN CRISTOBAL MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770533655
- **Authorized official:** MR. ANIBAL FALLA (CEO)
- **Authorized official phone:** (213) 413-4203

## Contact information

- **Practice address:** 1930 WILSHIRE BLVD, SUITE 405, LOS ANGELES, CA 90057-3605
- **Practice address phone:** (213) 413-4203
- **Practice address fax:** (213) 413-5615
- **Mailing address:** 1930 WILSHIRE BLVD, SUITE 405, LOS ANGELES, CA 90057-3605
- **Mailing address phone:** (213) 413-4203
- **Mailing address fax:** (213) 413-5615

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | W16925 | CA | Yes |

## Other

- **Enumeration date:** 05/11/2006
- **Last updated:** 10/28/2009