Provider Demographics
NPI:1932281813
Name:CRITEL, DELBERT DEAN (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DELBERT
Middle Name:DEAN
Last Name:CRITEL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1649
Mailing Address - Street 2:
Mailing Address - City:BIG BEAR LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:92315-1649
Mailing Address - Country:US
Mailing Address - Phone:909-866-6501
Mailing Address - Fax:909-878-8284
Practice Address - Street 1:41870 GARSTIN DRIVE
Practice Address - Street 2:BOX 1649
Practice Address - City:BIG BEAR LAKE
Practice Address - State:CA
Practice Address - Zip Code:92315-1649
Practice Address - Country:US
Practice Address - Phone:909-866-6501
Practice Address - Fax:909-878-8284
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3149367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ37830Medicare UPIN
CAZZZ02172ZMedicare ID - Type Unspecified