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NPI Code Detail

MEDICARE: JOHN DAVID CROFT PA

MEDICARE: JOHN DAVID CROFT PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA14549CA
2207P00000XEmergency Medicine PhysicianPA14549CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OPA145490OTHERCABLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437140746
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN DAVID CROFT PA
Provider Business Mailing Address
First Line : 500 W HOSPITAL RD
Second Line :
City : FRENCH CAMP
State : CA
Zip : 95231-9693
Country : US
Telephone Number : 209-468-6306
Fax Number : 209-468-7112
Provider Business Practice Location Address
First Line : 500 W HOSPITAL RD
Second Line :
City : FRENCH CAMP
State : CA
Zip : 95231-9693
Country : US
Telephone Number : 209-468-6306
Fax Number : 209-468-7112
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2005
Last Update Date : 04/22/2022

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