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JOHN A CROCKETT MD A PROFESSIONAL CORPORATION NPI 1265758460


NPI Information

NPI: 1265758460
Provider Name: JOHN A CROCKETT MD A PROFESSIONAL CORPORATION

Doing Business As: JOHN A CROCKETT MD, A PROFESSIONAL CORPORATION

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
240 LA CASA VIA STE 100
WALNUT CREEK, CA
ZIP 94598
Phone: (925) 519-2866
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JOHN A CROCKETT MD A PROFESSIONAL CORPORATION is a family medicine in Walnut Creek, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. JOHN A CROCKETT MD A PROFESSIONAL CORPORATION NPI is 1265758460. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As John A Crockett Md, A Professional Corporation.

The provider's business location address is:

240 LA CASA VIA STE 100
WALNUT CREEK, CA
ZIP 94598-863
Phone: (925) 519-2866
Fax: (925) 692-5522

The provider's authorized official is Karl F Stemmler .
The authorized official title is Credentialer and has the following contact phone number (619) 258-6200.

The enumeration date for this NPI number is 4/13/2010 and was last updated on 12/22/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & GynecologyG230620CALIFORNIANo
2207Q00000XFamily MedicineG230620CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11134221021MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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