Provider Demographics
NPI:1669828067
Name:CRESPO, MICHELLE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:CRESPO
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10037 SIDEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3545
Mailing Address - Country:US
Mailing Address - Phone:562-445-7789
Mailing Address - Fax:
Practice Address - Street 1:1400 S GRAND AVE
Practice Address - Street 2:SUITE 703
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3048
Practice Address - Country:US
Practice Address - Phone:213-741-1106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA151625207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine