Provider Demographics
NPI:1518266212
Name:CRONIN, CHRISTINE WELZMUELLER (LAC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:WELZMUELLER
Last Name:CRONIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:FRANCES
Other - Last Name:WELZMUELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4571 MARYLAND ST APT 5
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-1110
Mailing Address - Country:US
Mailing Address - Phone:619-296-3613
Mailing Address - Fax:
Practice Address - Street 1:4452 PARK BOULEVARD
Practice Address - Street 2:SUITE 312
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-1110
Practice Address - Country:US
Practice Address - Phone:619-296-3613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12604171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist