Provider Demographics
NPI:1205966199
Name:CROSSAN, JAMES P (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:CROSSAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 S HARBOR BLVD
Mailing Address - Street 2:DISNEYLAND RESORT, CAST HEALTH
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-2309
Mailing Address - Country:US
Mailing Address - Phone:714-781-4037
Mailing Address - Fax:714-781-4249
Practice Address - Street 1:1313 S HARBOR BLVD
Practice Address - Street 2:DISNEYLAND RESORT, CAST HEALTH
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-2309
Practice Address - Country:US
Practice Address - Phone:714-781-4037
Practice Address - Fax:714-781-4249
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG36966204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM