Individual
MR. CHARLES WILLIAM CROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRT
Contact information
Practice address
801 MAPLE ST, 801 MAPLE STREET, SAN MATEO, CA 94402-2302
(650) 347-1880
Mailing address
801 MAPLE ST, 801 MAPLE STREETT, SAN MATEO, CA 94402-2302
(650) 347-1880
(650) 342-8379
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
RHT3605
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ31682Z
—
CA
Enumeration date
03/08/2007
Last updated
01/07/2013
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