Individual
ANDREA CRACCHIOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 UCLA MEDICAL PLZ, SUITE 140, LOS ANGELES, CA 90095-8344
(310) 319-1234
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
(310) 319-1234
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A21344
CA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
A21344
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A213440
—
CA
Enumeration date
11/27/2006
Last updated
06/23/2010
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