MEDICARE: GREGORY H. CRAWFORD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	G39439	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023194545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY H. CRAWFORD MD

Provider Business Mailing Address
First Line	:	PO BOX 337
Second Line	:
City	:	PACIFIC GROVE
State	:	CA
Zip	:	93950-0337
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	940 BAYVIEW AVE
Second Line	:
City	:	PACIFIC GROVE
State	:	CA
Zip	:	93950-2402
Country	:	US
Telephone Number	:	831-373-2181
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	12/12/2009

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