Individual
CRYSTAL FAME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2212 E 4TH ST, SANTA ANA, CA 92705-3870
(714) 618-9540
Mailing address
2212 E 4TH ST, SANTA ANA, CA 92705-3870
(714) 618-9540
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A22816
CA
Other
Enumeration date
04/22/2021
Last updated
09/13/2024
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