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NPI Code Detail

MEDICARE: DR. MICHAEL CRADE M.D.

MEDICARE:  DR. MICHAEL  CRADE  M.D.
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
12085U0001XDiagnostic Ultrasound PhysicianG41634CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G41634OTHERCAMEDICAL BOARD CERT. NO

General Provider Information

NPI Number : 1295841930
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL CRADE M.D.
Provider Business Mailing Address
First Line : 3325 PALO VERDE AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90808-4132
Country : US
Telephone Number : 562-429-7100
Fax Number : 562-429-7132
Provider Business Practice Location Address
First Line : 3325 PALO VERDE AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90808-4132
Country : US
Telephone Number : 562-429-7100
Fax Number : 562-429-7132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 07/08/2007

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Directions to “ DR. MICHAEL CRADE M.D.” Practice Location

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