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NPI Code Detail

MEDICARE: CHRISTOPHER AARON CRISWELL M.A.

MEDICARE: CHRISTOPHER AARON CRISWELL M.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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1427181700
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER AARON CRISWELL M.A.
Provider Business Mailing Address
First Line : 2602 1/2 ADELBERT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90039-4017
Country : US
Telephone Number : 310-901-3033
Fax Number :
Provider Business Practice Location Address
First Line : 1328 2ND ST
Second Line :
City : SANTA MONICA
State : CA
Zip : 90401-1122
Country : US
Telephone Number : 310-394-6889
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 07/08/2007

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