MEDICARE: DR. ERIN NICOLE CRAWFORD 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
1	207L00000X	Anesthesiology Physician	A126742	CA

General Provider Information

NPI Number	:	1477811818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIN NICOLE CRAWFORD M.D.

Provider Business Mailing Address
First Line	:	13580 JADESTONE WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92130-2815
Country	:	US
Telephone Number	:	714-322-5597
Fax Number	:

Provider Business Practice Location Address
First Line	:	26522 LA ALAMEDA STE 370
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-6330
Country	:	US
Telephone Number	:	949-600-7864
Fax Number	:

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

Provider Enumeration Date	:	04/23/2012
Last Update Date	:	05/12/2021

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