Provider Demographics
NPI:1053735019
Name:TOBON-CHUNG, CRISTINA (FNP)
Entity type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:
Last Name:TOBON-CHUNG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1215 HOPLAND CT
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-1438
Mailing Address - Country:US
Mailing Address - Phone:619-410-9554
Mailing Address - Fax:877-992-4893
Practice Address - Street 1:4579 MAPLE AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-3154
Practice Address - Country:US
Practice Address - Phone:619-410-9554
Practice Address - Fax:877-992-4893
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000209363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily