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NPI Code Detail

MEDICARE: MRS. CLAIRE ANN KRISTL P.T., M.P.A.

MEDICARE: MRS. CLAIRE ANN KRISTL P.T., M.P.A.
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
1225100000XPhysical TherapistPT12926CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PT12926OTHERCASTATE LICENSE

General Provider Information

NPI Number : 1215992375
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CLAIRE ANN KRISTL P.T., M.P.A.
Provider Business Mailing Address
First Line : 39 MIRAMONTE RD
Second Line :
City : CARMEL VALLEY
State : CA
Zip : 93924-9433
Country : US
Telephone Number : 831-659-4274
Fax Number :
Provider Business Practice Location Address
First Line : 245 CROSSROADS BLVD
Second Line :
City : CARMEL
State : CA
Zip : 93923-8650
Country : US
Telephone Number : 831-620-0744
Fax Number : 831-620-0711
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 01/15/2008

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