Provider Demographics
NPI:1952465908
Name:LYNCH, CRISTAL MELANIE (MD)
Entity Type:Individual
Prefix:
First Name:CRISTAL
Middle Name:MELANIE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3440 LOMITA BLVD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4801
Mailing Address - Country:US
Mailing Address - Phone:310-539-5060
Mailing Address - Fax:310-539-7899
Practice Address - Street 1:3440 LOMITA BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4801
Practice Address - Country:US
Practice Address - Phone:310-539-5060
Practice Address - Fax:310-539-7899
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA48358207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG76563Medicare UPIN