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General NPI Number Information
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NPI Number | 1972466134
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Entity Type | Organization
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Legal Business Name | CROSSOVER HEALTH MEDICAL GROUP
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 340 DNA WAY BLDG 34, 4TH FL
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080
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Country | US
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Telephone | 971-500-2661
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Fax |
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Provider Business Mailing Address
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Address Line | 340 DNA WAY BLDG 34, 4TH FL
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SR. MANAGER OF CREDENTIALING
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Name | JENETTE HUNTER
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Credential | CPCS
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Telephone | 971-500-2661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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