Organization
SAN CRISTOBAL MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERNESTO Y CASILLAS MD (MEDICAL DIRECTOR)
(213) 413-4203
Entity
Organization
Contact information
Practice address
1127 WILSHIRE BLVD, STE 820, LOS ANGELES, CA 90017-3901
(213) 413-4203
Mailing address
1127 WILSHIRE BLVD, STE 820, LOS ANGELES, CA 90017-3901
(213) 413-4203
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
CA
Other
Enumeration date
04/25/2010
Last updated
04/25/2010
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