Provider Demographics
NPI:1538180153
Name:KRON, ELENA (ECT)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:KRON
Suffix:
Gender:F
Credentials:ECT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5091 VIA PLAYA LOS SANTOS
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-1554
Mailing Address - Country:US
Mailing Address - Phone:858-277-3509
Mailing Address - Fax:619-278-9615
Practice Address - Street 1:865 3RD AVE
Practice Address - Street 2:#121
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-1300
Practice Address - Country:US
Practice Address - Phone:619-427-2289
Practice Address - Fax:619-426-3427
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASL1219156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician