1518266212 NPI number — CHRISTINE WELZMUELLER CRONIN L.AC.

Table of content: CHRISTINE WELZMUELLER CRONIN L.AC. (NPI 1518266212)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518266212 NPI number — CHRISTINE WELZMUELLER CRONIN L.AC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRONIN
Provider First Name:
CHRISTINE
Provider Middle Name:
WELZMUELLER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L.AC.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WELZMUELLER
Provider Other First Name:
CHRISTINE
Provider Other Middle Name:
FRANCES
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1518266212
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4571 MARYLAND ST APT 5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92116-1110
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-296-3613
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4452 PARK BOULEVARD
Provider Second Line Business Practice Location Address:
SUITE 312
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92116-1110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-296-3613
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  12604 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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