Provider Demographics
NPI:1609203801
Name:JOHN V CROWDER JR M.D.
Entity Type:Organization
Organization Name:JOHN V CROWDER JR M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DARLEEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SUTCLIFFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-728-2020
Mailing Address - Street 1:160 GREEN VALLEY RD
Mailing Address - Street 2:SUITE 2020
Mailing Address - City:FREEDOM
Mailing Address - State:CA
Mailing Address - Zip Code:95019-3160
Mailing Address - Country:US
Mailing Address - Phone:831-728-2020
Mailing Address - Fax:831-728-4739
Practice Address - Street 1:930 SUNNYSLOPE RD
Practice Address - Street 2:SUITE E2
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5615
Practice Address - Country:US
Practice Address - Phone:831-637-0705
Practice Address - Fax:831-637-4701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00C336820207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty