Provider Demographics
NPI:1659338473
Name:CRUMPLER, HANS L (MD)
Entity Type:Individual
Prefix:
First Name:HANS
Middle Name:L
Last Name:CRUMPLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2437 FENTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-3517
Mailing Address - Country:US
Mailing Address - Phone:619-397-0866
Mailing Address - Fax:858-499-4039
Practice Address - Street 1:2437 FENTON ST STE A
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914
Practice Address - Country:US
Practice Address - Phone:619-394-0866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701302207Q00000X
AL28145207Q00000X
CAC161766207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891205UMedicaid
NC891205UMedicaid
G096868Medicare UPIN