Individual
DR. DAVID SHAN CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
911 SUNSET DR, HOLLISTER, CA 95023-5602
(831) 637-5771
(831) 638-9040
Mailing address
1745 SAN FELIPE RD STE 1, HOLLISTER, CA 95023-2540
(831) 636-1884
(831) 636-1775
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
G21002
CA
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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