DR. MICHAEL ANTHONY CRUCITT (NPI# 1588674741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588674741 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL ANTHONY CRUCITT |
| Credential | M.D. |
| Practice Address |
5525 Grossmont Center Dr La Mesa CA 91942-3009 |
| Mailing Address |
5524 Grossmont Center Dr. La Mesa CA 91942-3014 |
| Practice Telephone | 6196446750 |
| Mailing Telephone | 6196446750 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
C39374 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00C393740 | 05 |
| Street Address |
5525 GROSSMONT CENTER DR |
| City | LA MESA |
| State | CA |
| Zip Code | 91942-3009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164421012 | Lee Hyland Remington-boone | Family Medicine | 5525 Grossmont Center Dr, Suite 200, La Mesa, CA 91942-3009 | 2005-07-21 |
| 1679023303 | James Sullivan | Pharmacist | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2016-10-05 |
| 1033565940 | James Williams | Pharmacist | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2016-05-10 |
| 1255792438 | Lisa Schnurr | Family Medicine | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2016-03-15 |
| 1417316696 | Hollis Taggart Stahl | Physician Assistant | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2016-02-17 |
| 1598124133 | Hong Tran | Pharmacist | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2016-02-10 |
| 1578928321 | Thanhtruc Hoang Phan | Nurse Practitioner | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2015-12-22 |
| 1730593559 | Susette Var | Family Medicine | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2014-06-19 |
| 1154746535 | Victoria Sharma Md Inc | Specialist | 5525 Grossmont Center Dr, 602, La Mesa, CA 91942-3009 | 2014-02-21 |
| 1487093126 | Maila Alindog Marinas | Registered Nurse | 5525 Grossmont Center Dr, La Mesa, CA 91942-3009 | 2013-06-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902453723 | Nicole V Zappelli | Case Manager/Care Coordinator | 4990 William Ave., La Mesa, CA 91942 | 2019-08-26 |
| 1770059834 | Natalie Ngoc Nguyen | Physician Assistant | 5555 Grosmont Center Dr., La Mesa, CA 91942 | 2018-10-16 |
| 1194204297 | Courtney Pietsch | Nurse Practitioner | 8851 Health Center Circle, Suite #603, La Mesa, CA 91942 | 2018-08-09 |
| 1295214773 | Megan Gordon | Behavior Technician | 6116 Horton Dr, La Mesa, CA 91942 | 2018-08-07 |
| 1356836548 | Kimberly Denise Davis | Counselor | 3845 Avocado School Road, El Cajon, CA 91942 | 2018-06-29 |
| 1366932113 | Melanie Joyce Shepard | Physician Assistant | 7051 Alvarado Road, Suite 201, La Mesa, CA 91942 | 2018-05-17 |
| 1871013532 | Low Dental, A.p.c. | Public Health or Welfare | 7872 La Mesa Blvd., La Mesa, CA 91942 | 2017-06-23 |
| 1275069437 | Ardel Ayala | Respiratory Therapist, Registered | 5800 Lake Murray Blvd. Unit 15, La Mesa, CA 91942 | 2017-05-10 |
| 1285007583 | Counseling & Behavioral Specialists | Marriage & Family Therapist | 5520 Wellesley Street, Ste 204, La Mesa, CA 91942 | 2015-11-09 |
| 1285001875 | Emily Shozaki Rizo | Nurse Practitioner | 6285 Meadowcrest Drive, La Mesa, CA 91942 | 2015-08-31 |
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| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699737676 | Melissa S Copeland | Internal Medicine | 4215 Spring St Ste 125, La Mesa, CA 91941-7983 | 2006-04-05 |
| 1154618593 | Igor Medic | Internal Medicine | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2011-07-06 |
| 1629286505 | Reema R. Batra | Internal Medicine | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2007-05-21 |
| 1134280605 | David J Bodkin | Internal Medicine | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2006-12-12 |
| 1164583639 | Kai Zu | Internal Medicine | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2006-12-12 |
| 1124058870 | Michelle Kiluk | Internal Medicine | 5555 Grossmont Center Dr, La Mesa, CA 91942-3019 | 2006-07-04 |
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| 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.