MEDICARE: W. ROBERT CRUMPTON, 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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1629267687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	W. ROBERT CRUMPTON, M.D.

Provider Business Mailing Address
First Line	:	14642 NEWPORT AVE STE 200
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92780-6058
Country	:	US
Telephone Number	:	714-669-4467
Fax Number	:	714-669-4088

Provider Business Practice Location Address
First Line	:	14642 NEWPORT AVE STE 200
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92780-6058
Country	:	US
Telephone Number	:	714-669-4467
Fax Number	:	714-669-4088

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. WILLIAM ROBERT CRUMPTON
Credential	:	M.D.
Telephone Number	:	714-669-4467

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	10/16/2007

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