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General NPI Number Information
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NPI Number | 1962673434
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Entity Type | Organization
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Legal Business Name | DAVID M. CRNIC, MD
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 307 PLACENTIA AVE STE 110
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3307
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Country | US
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Telephone | 949-645-2288
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Fax | 949-574-8161
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Provider Business Mailing Address
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Address Line | 307 PLACENTIA AVE STE 110
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3307
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Country | US
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Telephone | 949-645-2288
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Fax | 949-574-8161
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID MICHAEL CRNIC
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Credential | MD
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Telephone | 949-645-2288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G46173
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License Number State | CA
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