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Individual
GARY CRITSER
Active
Individual
GARY CRITSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A5798
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020A57980
BLUE SHIELD
CA
Enumeration date
01/31/2006
Last updated
01/28/2015
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