Individual
CRISTINE DESCALLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4601 DALE RD, MODESTO, CA 95356-9718
(209) 735-5000
Mailing address
1641 N RIPON RD APT 505, RIPON, CA 95366-9818
(914) 479-8760
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A159251
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/09/2014
Last updated
12/17/2021
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