Provider Demographics
NPI:1952333650
Name:CRISOL, GERMAN E (MD)
Entity Type:Individual
Prefix:DR
First Name:GERMAN
Middle Name:E
Last Name:CRISOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6485 DAY ST STE 202
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-0931
Mailing Address - Country:US
Mailing Address - Phone:951-653-3500
Mailing Address - Fax:951-653-3330
Practice Address - Street 1:6485 DAY ST STE 202
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-0931
Practice Address - Country:US
Practice Address - Phone:951-653-3500
Practice Address - Fax:951-653-3330
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA-68389207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine