Croughan, David R

Croughan, David R is an individual health care provider with primary practice located at 2 W Fern Ave , Redlands CA 92373-5916. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Croughan, David R can be contacted via phone (909) 793-3311.

Contact Information

Primary practice address
2 W Fern Ave Redlands CA 92373-5916
Fax: (909) 796-4158
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X A36331 California

Profile Details

NPI number 1801820949
LBN Legal business name Croughan, David R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801820949 NPPES
California MEDICAID 00A363310

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