Provider Demographics
NPI:1568862175
Name:CROSDALE, CHRISTOPHER ALLAN
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ALLAN
Last Name:CROSDALE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 HOTEL CIRCLE CT STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3423
Mailing Address - Country:US
Mailing Address - Phone:626-698-8240
Mailing Address - Fax:
Practice Address - Street 1:4420 HOTEL CIRCLE CT STE 205
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3423
Practice Address - Country:US
Practice Address - Phone:626-698-8240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator