| Organization Name: | LUZ TRISTAN MD INC |
| NPI Number: | 1801037577 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LUZ E TRISTAN (PEDIATRICIAN) |
| Mailing Address: | 408 E 3rd St Ste D Calexico |
| State: | CA US |
| Postal Code: | 922312854 |
| Phone Number: | 7607685246 |
| Fax Number: | 7607682234 |
| NPI Enumeration Date: | 03/10/2009 |
| NPI Last Update Date: | 03/10/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | A064252 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |