Individual
CHRISTHI TANZANIA VAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10526 DUBNOFF WAY, NORTH HOLLYWOOD, CA 91606-3921
(818) 755-4950
(818) 752-0783
Mailing address
10526 DUBNOFF WAY, NORTH HOLLYWOOD, CA 91606-3921
(818) 755-4950
(818) 752-0783
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
10/03/2018
Last updated
10/09/2018
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