Luis Cristobal-Gallardo

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

PT292596 Issued in CA

Practice address

103 E Main St
Ripon, CA 95366-2416

Phone

(209) 253-0740

NPI assigned

Jan 11, 2019

Last updated

Jan 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• California Physical, Occupational, Speech and Hand Therapy, Inc.

  dba California Rehabilittion

  • Neurorehabilitation Occupational Therapist
  • Modesto, CA
  • NPI 1841357233
  NPD (past)

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1477027530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 SPYRES WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E MAIN ST",
            "city": "RIPON",
            "state": "CA",
            "postal_code": "953662416",
            "telephone_number": "209-253-0740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4660 Spyres Way",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953569804",
            "country_code": "US",
            "telephone_number": "209-578-3290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRISTOBAL-GALLARDO",
        "first_name": "LUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "PT292596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Bull
• California Connections Academy @ Ripon
• Elizabeth Campos-Martinez, LCSW
• Amandeep K Chahal
• Kaitlin Courtright
• Michael Thomas Crum, D.D.S.
• Richard L Crum, DDS
• Erin Colleen Dale, LCSW
• James Jeffrey Daley, M.D.
• Darwin Van Wyngarden a Professional Chiropractic Corporation (Almond Valley Chiropractic)

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Ripon, CA
• Providers in Ripon, CA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; 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.