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General NPI Number Information
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NPI Number | 1194758219
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Entity Type | Individual
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Provider Name | ALLYSON A. KRESHAK M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 200 W ARBOR DR MAILCODE 8925
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City | SAN DIEGO
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State | CA
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Zip | 92103-9001
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Country | US
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Telephone | 267-872-3916
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Fax | 858-715-6361
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Provider Business Mailing Address
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Address Line | 200 W ARBOR DR MAILCODE 8925
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City | SAN DIEGO
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State | CA
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Zip | 92103-9001
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Country | US
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Telephone | 267-872-3916
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Fax | 858-715-6361
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD13560
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 207PT0002X
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Taxonomy Name | Medical Toxicology (Emergency Medicine) Physician
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License Number | A102811
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A102811
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD424637
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License Number State | PA
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