Provider Demographics
NPI:1962836783
Name:CROWLEY, CHRISTOPHER S (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:S
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 EUCLID AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2978
Mailing Address - Country:US
Mailing Address - Phone:619-267-8303
Mailing Address - Fax:619-267-4835
Practice Address - Street 1:655 EUCLID AVE STE 401
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2978
Practice Address - Country:US
Practice Address - Phone:619-267-8303
Practice Address - Fax:619-267-4835
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA13418207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology