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NPI Code Detail

MEDICARE: DR. JEAN CRANE MD

MEDICARE: DR. JEAN CRANE 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
1207Q00000XFamily Medicine PhysicianG51147CA
2207Q00000XFamily Medicine PhysicianMD60081868WA

General Provider Information

NPI Number : 1134113731
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEAN CRANE MD
Provider Business Mailing Address
First Line : 4540 E ALAMOS AVE
Second Line :
City : FRESNO
State : CA
Zip : 93726-1218
Country : US
Telephone Number : 559-224-7646
Fax Number : 559-476-9601
Provider Business Practice Location Address
First Line : 201 ALPHA WAY
Second Line :
City : CLE ELUM
State : WA
Zip : 98922-1045
Country : US
Telephone Number : 509-674-5331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2005
Last Update Date : 05/11/2010

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