Healthcare Provider Details

I. General information

NPI: 1285656587
Provider Name (Legal Business Name): MR. CRAIG S CULVER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

753 W LANCASTER BLVD
LANCASTER CA
93534-3118
US

IV. Provider business mailing address

753 W LANCASTER BLVD
LANCASTER CA
93534-3118
US

V. Phone/Fax

Practice location:
  • Phone: 661-948-4573
  • Fax: 661-723-0813
Mailing address:
  • Phone: 661-948-4573
  • Fax: 661-723-0813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA921
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: