Individual
DR. CURTIS LISANTE CETRULO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8635 W 3RD ST STE 770W, LOS ANGELES, CA 90048-6101
(310) 423-8350
(310) 423-4145
Mailing address
4140 W 190TH ST, TORRANCE, CA 90504-5513
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A88073
CA
208600000X
Surgery Physician
A88073
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A880730
BLUE SHIELD PROV. NUMBER
CA
05
—
00A880730
—
CA
Enumeration date
10/09/2007
Last updated
12/07/2023
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