Organization
ERWINN MARTIN C SISTOZA, M.D.,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERWINN C SISTOZA M.D. (PRESIDENT)
(310) 348-9138
Entity
Organization
Contact information
Practice address
1711 W TEMPLE ST, SUITE 5638, LOS ANGELES, CA 90026-5421
(310) 989-6107
(310) 989-6519
Mailing address
6355 GREEN VALLEY CIR, UNIT 115, CULVER CITY, CA 90230-7073
(310) 348-9138
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
A76101
CA
208000000X
Pediatrics Physician
A76101
CA
Other
Enumeration date
07/30/2007
Last updated
01/14/2008
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