Provider Demographics
NPI:1881640423
Name:RUTH ANN CRYSTAL, MD, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:RUTH ANN CRYSTAL, MD, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CRYSTAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-858-6800
Mailing Address - Street 1:3200 MIDDLEFIELD RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-3046
Mailing Address - Country:US
Mailing Address - Phone:650-858-6800
Mailing Address - Fax:650-858-6868
Practice Address - Street 1:3200 MIDDLEFIELD RD
Practice Address - Street 2:SUITE C
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-3046
Practice Address - Country:US
Practice Address - Phone:650-858-6800
Practice Address - Fax:650-858-6868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ02416ZMedicare PIN