Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 058457 | GA |
Y | 207N00000X | Dermatologist | A107312 | CA |
N | 207ND0101X | MOHS-Micrographic Surgeon | A107312 | CA |
N | 207NS0135X | Procedural Dermatology | A107312 | CA |
NPI | 1497931380 |
---|---|
Provider Name | Dr. Christopher V Crosby |
First Address | La Mesa, CA 91942-3068 |
Second Address | La Mesa, CA 91942-3068 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2008 |
Last Update Date | 24/09/2020 |