Provider Demographics
NPI:1245653146
Name:CRIQUI, MICHAEL HONORE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HONORE
Last Name:CRIQUI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9500 GILMAN DR
Mailing Address - Street 2:MAIL CODE 0607
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92093-0607
Mailing Address - Country:US
Mailing Address - Phone:858-534-3722
Mailing Address - Fax:858-246-0298
Practice Address - Street 1:9500 GILMAN DR
Practice Address - Street 2:MAIL CODE 0607
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-0607
Practice Address - Country:US
Practice Address - Phone:858-534-3722
Practice Address - Fax:858-246-0298
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
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Provider Licenses
StateLicense IDTaxonomies
CAA242832083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine