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General NPI Number Information
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NPI Number | 1679014922
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Entity Type | Individual
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Provider Name | TREVOR CROSSLEY D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/19/2017
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 9625 BLACK MOUNTAIN RD STE 208
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City | SAN DIEGO
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State | CA
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Zip | 92126-4598
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Country | US
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Telephone | 858-634-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 736 W 4TH AVE
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City | LA HABRA
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State | CA
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Zip | 90631-6012
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Country | US
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Telephone | 760-500-3570
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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 | 33819
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License Number State | CA
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