Individual
LUIS CRISTOBAL-GALLARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 E MAIN ST, RIPON, CA 95366-2416
(209) 253-0740
Mailing address
4660 SPYRES WAY, MODESTO, CA 95356-9804
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
PT292596
CA
Other
Enumeration date
01/11/2019
Last updated
01/11/2019
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