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MONTECRISTO MEDICAL PC
NPI 1699268631
Clinic/Center - Primary Care in Van Nuys, CA

Active since June 13, 2018CLIA 05D1097025 · Waiver
14649 VICTORY BLVD STE 20, VAN NUYS, CA 91411(818) 786-8396(818) 901-7128 Get Directions Write a Review

NPPES record last updated: October 23, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 23, 2019, Jun 16, 2018 (2 updates tracked since 2018).

About Montecristo Medical Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MONTECRISTO MEDICAL PC (NPI 1699268631) is a healthcare organization registered as a primary care in Van Nuys, California and active in the NPI registry since June 2018. The organization holds a CLIA Waiver certificate valid through March 16, 2027, maintains a secondary practice location in Van Nuys, and lists Anita Emperatriz Gonzalez, President, as its authorized official.

NPPES Registry Identity

NPI1699268631
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameMONTECRISTO MEDICAL PC
Location Address14649 VICTORY BLVD STE 20Van Nuys, CA 91411
Mailing Address14649 Victory Blvd Ste 20Van Nuys, CA 91411-4101 · (818) 786-8396 · Fax (818) 901-7128
Phone(818) 786-8396
Fax(818) 901-7128
Organization SubpartNo
Authorized OfficialAnita Emperatriz GonzalezPresident · (818) 568-6923
Enumeration DateJune 13, 2018
Last NPPES UpdateOctober 23, 20192 updates tracked since enumeration
✔ NPI 1699268631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in CA · A100277
14649 VICTORY BLVD STE 20, Van Nuys, CA 91411
Open in Google Maps ↗

Secondary Practice Location 1

Location 114350 Victory Blvd Ste 3Van Nuys, CA 91401-1994 · Phone (818) 786-8396 · Fax (818) 901-7128

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1097025

Montecristo Medical PC · Van Nuys, CA
Active · expires Mar 16, 2027
CLIA Number05D1097025
Laboratory TypePhysician Office
Certificate Effective DateMarch 17, 2025
Certificate Expiration DateMarch 16, 2027
Laboratory DirectorAnita E. Gonzalez, MD
Laboratory Phone(818) 786-8396
Laboratory LocationMontecristo Medical PC14649 Victory Blvd Suite 20, Van Nuys, CA 91401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER PEARL KROHN MMSC, PA, RDN, CDE
Physician Assistant
14649 VICTORY BLVD STE 20
VAN NUYS, CA 91411
Los Angeles County (818) 786-8396
ADRIANA CORTEZ
Physician Assistant
14649 VICTORY BLVD STE 20
VAN NUYS, CA 91411
Los Angeles County (818) 786-8396
DR. ANITA EMPERATRIZ GONZALEZ M.D.
General Practice
14649 VICTORY BLVD STE 20
VAN NUYS, CA 91411
Los Angeles County (818) 786-8396

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Montecristo Medical PC's NPI number?

The NPI number for Montecristo Medical PC is 1699268631. It was assigned to this organization in the NPPES registry on June 13, 2018.

Where is Montecristo Medical PC located?

Montecristo Medical PC is located at 14649 Victory Blvd Ste 20, Van Nuys, CA 91411. The listed phone number is (818) 786-8396.

What is Montecristo Medical PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Montecristo Medical PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1097025) is associated with this NPI, valid through March 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Montecristo Medical PC was last updated on October 23, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.