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General NPI Number Information
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NPI Number | 1386005767
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Entity Type | Individual
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Provider Name | CRISTIN JADE THOMPSON D.C.
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Gender | Female
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Dates
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Enumeration Date | 03/14/2016
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Last Update Date | 03/14/2016
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Provider Practice Location Address
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Address Line | 36101 BOB HOPE DR B-3
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-2001
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Country | US
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Telephone | 703-862-1562
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 SECOND ST. R-103
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City | CORONADO
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State | CA
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Zip | 92118
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Country | US
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Telephone | 703-862-1562
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 33505
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License Number State | CA
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