Individual
MRS. CRYSTAL MAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
111 N SEPULVEDA BLVD STE 210, MANHATTAN BEACH, CA 90266-6849
(310) 379-2134
Mailing address
1218 EDITH AVE APT G, ALHAMBRA, CA 91803-2476
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/03/2017
Last updated
07/26/2017
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