Individual
CHRYSTAL AMALIA COLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
12730 HAWTHORNE BLVD STE D, HAWTHORNE, CA 90250-3919
(310) 220-0914
Mailing address
1109 PACIFIC AVE, LONG BEACH, CA 90813-3023
(562) 454-3353
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
74919
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74919
—
CA
Enumeration date
02/07/2019
Last updated
02/07/2019
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