Individual
DR. CRYSTAL ELIZABETH FANCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2200 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2312
(310) 582-7096
(310) 582-7236
Mailing address
1520 SAN PABLO ST STE 4300, LOS ANGELES, CA 90033-5330
(323) 442-8168
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
A162160
CA
390200000X
Student in an Organized Health Care Education/Training Program
A162160
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/22/2014
Last updated
07/23/2021
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