| Jeffrey Crudo Md Corp | |
|
1100 S Coast Hwy Ste 206 Laguna Beach CA 92651-2972 | |
| (949) 715-6890 | |
| Not Available |
| Full Name | Jeffrey Crudo Md Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | 1100 S Coast Hwy Ste 206, Laguna Beach, California |
| Authorized Official Name and Position | Jeffrey Crudo (OWNER) |
| Authorized Official Contact | 9497156890 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey Crudo Md Corp 1100 S Coast Hwy Ste 206 Laguna Beach CA 92651-2972 Ph: (949) 715-6890 | Jeffrey Crudo Md Corp 1100 S Coast Hwy Ste 206 Laguna Beach CA 92651-2972 Ph: (949) 715-6890 |
| NPI Number | 1821673062 |
|---|---|
| Provider Enumeration Date | 03/09/2021 |
| Last Update Date | 08/17/2021 |
| Medicare PECOS PAC ID | 7911301155 |
|---|---|
| Medicare Enrollment ID | O20210810001495 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821673062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeffrey John Crudo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508987371 PECOS PAC ID: 5092767897 Enrollment ID: I20150507002116 |
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