Individual
CHAD CRAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
12194 WAVERLY DOWNS LN, SAN DIEGO, CA 92128-3708
(858) 531-1391
Mailing address
12194 WAVERLY DOWNS LN, SAN DIEGO, CA 92128-3708
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1095572
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1095572
NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
—
Enumeration date
04/30/2014
Last updated
04/30/2014
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