Individual
ELLEN B CROWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
115 LOS PADRES DR, THOUSAND OAKS, CA 91361-1317
(805) 380-3313
(805) 449-0091
Mailing address
115 LOS PADRES DR, THOUSAND OAKS, CA 91361-1317
(805) 380-3313
(805) 449-0091
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
01036964
IN
207Q00000X
Family Medicine Physician
G89024
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000365275
ANTHEM
IN
05
—
104748978
—
MI
05
—
200072690
—
IN
01
—
P00608083
RAIL ROAD MEDICARE
IN
Enumeration date
04/26/2006
Last updated
04/25/2012
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