Provider Demographics
NPI:1629267687
Name:W. ROBERT CRUMPTON, M.D.
Entity Type:Organization
Organization Name:W. ROBERT CRUMPTON, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:CRUMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-669-4467
Mailing Address - Street 1:14642 NEWPORT AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6058
Mailing Address - Country:US
Mailing Address - Phone:714-669-4467
Mailing Address - Fax:714-669-4088
Practice Address - Street 1:14642 NEWPORT AVE STE 200
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6058
Practice Address - Country:US
Practice Address - Phone:714-669-4467
Practice Address - Fax:714-669-4088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA43201Medicare UPIN
CAG27062AMedicare PIN