Provider Demographics
NPI:1902823701
Name:ARMADA, CRISOSTOMO ALEJO JR (DO)
Entity Type:Individual
Prefix:DR
First Name:CRISOSTOMO
Middle Name:ALEJO
Last Name:ARMADA
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:10399 LEMON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-3771
Mailing Address - Country:US
Mailing Address - Phone:909-373-0216
Mailing Address - Fax:909-373-1902
Practice Address - Street 1:10399 LEMON AVE STE 101
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91737-3771
Practice Address - Country:US
Practice Address - Phone:909-373-0216
Practice Address - Fax:909-373-1902
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2023-02-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A5158207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020A51581OtherMEDICARE INDIVIDUAL PTAN
CA00AX51580OtherMEDI-CAL
CA00AX51580OtherMEDI-CAL