Organization
JOHN R CREW MD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R CREW M.D. (PRESIDENT)
(650) 994-2700
Entity
Organization
Contact information
Practice address
1850 SULLIVAN AVE, SUITE 115, DALY CITY, CA 94015-2221
(650) 994-2700
(650) 755-0410
Mailing address
PO BOX 2299, DALY CITY, CA 94017-2299
(650) 994-2700
(650) 755-0410
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C20787
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C207870
—
CA
01
—
1215042163
NPI SOLO
CA
Enumeration date
10/31/2007
Last updated
12/26/2007
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