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General NPI Number Information
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NPI Number | 1457970303
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Entity Type | Individual
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Provider Name | KRISTIN ROSE CREEL MD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 7850 VISTA HILL AVE
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City | SAN DIEGO
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State | CA
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Zip | 92123-2717
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Country | US
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Telephone | 858-836-8434
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1770
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City | LA MESA
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State | CA
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Zip | 91944-1770
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Country | US
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Telephone | 619-464-1165
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 196802
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A187820
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License Number State | CA
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