Colon, Chrystal Amalia

Colon, Chrystal Amalia is an individual health care provider with primary practice located at 12730 Hawthorne Blvd Ste D , Hawthorne CA 90250-3919. She recently has only one registered license in Dental Providers / Dental Assistant, which is considered as her primary health care specialty. Colon, Chrystal Amalia can be contacted via phone (310) 220-0914.

Contact Information

Primary practice address
12730 Hawthorne Blvd Ste D Hawthorne CA 90250-3919
Phone: (310) 220-0914
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Assistant 126800000X 74919 California

Profile Details

NPI number 1649735242
LBN Legal business name Colon, Chrystal Amalia
Credentials Registered Dental Assistant (RDA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2019
Last updated Feb 7th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649735242 NPPES
California MEDICAID 74919

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