Healthcare Provider Details

I. General information

NPI: 1679778187
Provider Name (Legal Business Name): KRISTOPHER STROMMEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 E HIGHWAY 246 SUITE 300
BUELLTON CA
93427-9645
US

IV. Provider business mailing address

4791 CAMEO DR
SANTA MARIA CA
93455-4523
US

V. Phone/Fax

Practice location:
  • Phone: 805-688-6550
  • Fax:
Mailing address:
  • Phone: 805-714-2405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP18379
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: