PHILLIP M CROAK (NPI# 1023513165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023513165 |
| Entity Type | Individual |
| Full Name | PHILLIP M CROAK |
| Practice Address |
5025 E Pacific Coast Hwy Apt P231 Long Beach CA 90804-3239 |
| Practice Telephone | 2535793811 |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-03-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
5025 E PACIFIC COAST HWY APT P231 |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90804-3239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821616673 | Exporter Medical LLC | Durable Medical Equipment & Medical Supplies | 2990 E. Pacific Coast Hwy., Suite B, Long Beach, CA 90804 | 2020-07-08 |
| 1700436094 | Magdalema Ballesteros-reynolds | Technician | 844 Ohio Ave, Long Beach, CA 90804 | 2019-09-18 |
| 1093365447 | Edelmira D Sanchez | Technician | 837 Bennett Ave, Long Beach, CA 90804 | 2019-09-18 |
| 1164980165 | Carlton Fortenberry | Behavior Technician | 775 Obispo Ave., Unit 1, Long Beach, CA 90804 | 2019-03-08 |
| 1427522812 | Western Dental Services, Inc. | Dentist | 2306 E 7th Street, Long Beach, CA 90804 | 2019-01-18 |
| 1124557657 | Keav Siv Khov | Social Worker | 4510 East Pacific Coast Highway, Suite 600, Long Beach, CA 90804 | 2017-06-08 |
| 1265966576 | Kensie Hoag | Social Worker | 4510 E PCh, Suite 305, Long Beach, CA 90804 | 2017-04-13 |
| 1528424389 | Rem Pacific Sleep Center, Inc. | Specialist/Technologist | 2990 E. Pacific Coast Hwy, Suite A, Long Beach, CA 90804 | 2016-01-10 |
| 1417326935 | Kelli Ann Carlson | Student in an Organized Health Care Education/Training Program | 2025 E. 7th Street, Long Beach, CA 90804 | 2015-09-15 |
| 1487059010 | Kenenth K. Lee, D.d.s., Inc. | Preferred Provider Organization | 4755 E. Anaheim St., Long Beach, CA 90804 | 2014-10-24 |
| Find all providers in zip 90804 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619509734 | Albert Navarro | Specialist/Technologist | 2605 E Adams St, Long Beach, CA 90810-1504 | 2020-02-06 |
| 1902468408 | Adriana Raya | Specialist/Technologist | 2001 Santa Fe Ave, Long Beach, CA 90810-4068 | 2019-07-03 |
| 1861050478 | Cody Patrick Morris | Specialist/Technologist | 2225 Euclid Ave, Long Beach, CA 90815-2518 | 2019-05-30 |
| 1548750862 | Fumiya Nakata | Specialist/Technologist | 445 E 3rd St Apt 301, Long Beach, CA 90802-3195 | 2018-05-11 |
| 1083117832 | Amos Hirsh | Specialist/Technologist | 3409 E 1st St., B, Long Beach, CA 90803 | 2018-03-16 |
| 1124521034 | Cindy Aboud | Specialist/Technologist | 533 Newport Ave Apt 4, Long Beach, CA 90814-4766 | 2018-03-16 |
| 1831692086 | Vivian Tanudjaja | Specialist/Technologist | 6481 Atlantic Ave Apt 135, Long Beach, CA 90805-2339 | 2018-03-14 |
| 1467953836 | Shannon Busse | Specialist/Technologist | 4908 E Los Coyotes Diagonal Apt 1, Long Beach, CA 90815-2838 | 2018-02-21 |
| 1609376391 | Andy N Nguyen | Specialist/Technologist | 1880 W Burnett St, Long Beach, CA 90810-3222 | 2018-02-19 |
| 1134629975 | Tyler Augenfeld | Specialist/Technologist | 533 Newport Ave Apt 2, Long Beach, CA 90814-4764 | 2018-02-19 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90804 |
Please comment or provide details below to improve the information on PHILLIP M CROAK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.