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Individual

ALAN KRYSTAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1582 W SAN MARCOS BLVD STE 100, SAN MARCOS, CA 92078-4081
(760) 591-9975
Mailing address
1582 W SAN MARCOS BLVD STE 100, SAN MARCOS, CA 92078-4081
(760) 591-9975

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G74558
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G745580
CA
01
P00290917
RAILROAD MEDICARE
CA
Enumeration date
02/09/2007
Last updated
07/20/2011
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