Provider Demographics
NPI:1417075029
Name:CRIS ARMADA JR. D.O.INC.
Entity type:Organization
Organization Name:CRIS ARMADA JR. D.O.INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARMADA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:909-373-0216
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5158207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1417075029OtherGROUP NPI
CA00AX51580Other00AX51580
CAZZZ06898ZOtherMEDICARE GRP PTAN