Individual
DR. STEPHEN KRICKL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 N MCDOWELL BLVD, PETALUMA, CA 94954-2339
(707) 778-1111
Mailing address
18000 STUDEBAKER RD, FOURTH FLOOR, CERRITOS, CA 90703-2679
(562) 468-0227
(562) 924-5830
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
G62551
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G625510
—
CA
Enumeration date
07/12/2006
Last updated
01/28/2010
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