Crandall, James Berrett
Crandall, James Berrett is an individual health care provider with primary practice located at 7484 University Avenue Suite 150, La Mesa CA 91941-6084. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Crandall, James Berrett can be contacted via phone (619) 460-2500.Contact Information
Primary practice address
7484 University Avenue Suite 150
La Mesa CA 91941-6084
Phone: (619) 460-2500
Fax: (619) 462-3169
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 24760 | California |
Profile Details
| NPI number | 1104024660 |
|---|---|
| LBN Legal business name | Crandall, James Berrett |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104024660 | NPPES |
| California | MEDICAID | B2476001 |
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