Provider Demographics
NPI:1770591521
Name:CRYSTAL, FRANKLIN ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:ALLEN
Last Name:CRYSTAL
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:225 W MADISON AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-3454
Mailing Address - Country:US
Mailing Address - Phone:619-442-0844
Mailing Address - Fax:619-442-7399
Practice Address - Street 1:225 W MADISON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020
Practice Address - Country:US
Practice Address - Phone:619-442-0844
Practice Address - Fax:619-442-7399
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG24134207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G241340Medicaid
A42172Medicare UPIN
CA00G241340Medicaid
CAW412Medicare PIN