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General NPI Number Information
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NPI Number | 1396812475
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Entity Type | Organization
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Legal Business Name | TERRENCE W CROUCH MD INC
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 01/14/2011
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Provider Practice Location Address
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Address Line | 655 EUCLID AVE SUITE 401
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City | NATIONAL CITY
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State | CA
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Zip | 91950
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Country | US
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Telephone | 619-267-1556
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Fax | 619-267-2420
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Provider Business Mailing Address
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Address Line | 655 EUCLID AVE SUITE 401
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City | NATIONAL CITY
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State | CA
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Zip | 91950
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Country | US
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Telephone | 619-267-1556
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Fax | 619-267-2420
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | TERRENCE WAYNE CROUCH
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Credential | MD
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Telephone | 619-267-1556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | G47259
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License Number State | CA
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