Healthcare Provider Details

I. General information

NPI: 1487601357
Provider Name (Legal Business Name): DAVID CRUTCHER LAGREW JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOAG DR
NEWPORT BEACH CA
92663-4162
US

IV. Provider business mailing address

2995 RED HILL AVE STE 100
COSTA MESA CA
92626-5984
US

V. Phone/Fax

Practice location:
  • Phone: 949-763-7451
  • Fax: 949-763-7451
Mailing address:
  • Phone: 949-763-7450
  • Fax: 949-763-7451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberG49681
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: