NPIMap

Organization Active NPI

San Cristobal Medical Group, Inc

  • Interventional Pain Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1033436464
Registry record updated Apr 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
SAN CRISTOBAL MEDICAL GROUP, INC
Practice address
1127 Wilshire Blvd
Ste 820
Los Angeles, CA 90017-3901
Phone
(213) 413-4203
NPI assigned
Apr 25, 2010
Last updated
Apr 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ernesto Y Casillas, MD
Title
Medical Director
Phone
(213) 413-4203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X CA Primary

Addresses

Primary practice location

1127 Wilshire Blvd
Ste 820
Los Angeles, CA 90017-3901

Mailing address

1127 Wilshire Blvd
Ste 820
Los Angeles, CA 90017-3901
Phone (213) 413-4203

National Provider Directory

National Provider Directory
Tax ID family
San Cristobal Medical Group Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1127 Wilshire Blvd
Ste 820
Los Angeles, CA 90017
Phone (213) 413-4203

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272153600000",
    "number": "1033436464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD",
            "address_2": "STE 820",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173901",
            "telephone_number": "213-413-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD",
            "address_2": "STE 820",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173901",
            "telephone_number": "213-413-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN CRISTOBAL MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-25",
        "last_updated": "2010-04-25",
        "status": "A",
        "authorized_official_last_name": "CASILLAS",
        "authorized_official_first_name": "ERNESTO",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "213-413-4203",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.